Original Paper: Esophagus
Dilated Intercellular Spaces as Markers of Reflux Disease: Histology, Semiquantitative Score and Morphometry upon Light MicroscopyVillanacci V.a · Grigolato P.G.a · Cestari R.b · Missale G.b · Cengia G.b · Klersy C.c · Rindi G.a
aPathology Service 2, bDepartment of Surgery (Digestive Endoscopy), University of Brescia and Spedali Civili, Brescia, and cBiometric and Clinical Epidemiology Service, IRCCS Policlinico San Matteo, Pavia, Italy
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Background and Aims: A recent electron microscopy study suggested that dilated intercellular spaces (DIS) are specific for acid reflux-damaged esophageal epithelium. Electron microscopy is, however, expensive and difficult to apply to routine biopsies. The aims of this study are to establish a method for assessing DIS on light microscopy of esophageal biopsies and to estimate its association with current clinicopathological parameters of esophagitis. Materials and Methods: 21 patients with reflux symptoms were investigated. Light microscopy biopsies were assessed for DIS size by a semiquantitative method and computer-assisted, static morphometry. A DIS score accounting for DIS size and distribution was assigned to each patient and its association with 30 clinicopathological variables investigated by univariate and multivariate logistic regression. Results: Both the semiquantitative method and static morphometry identified 4 different classes of DIS size. The DIS score was significantly and independently associated with the esophageal symptoms score, the histological score of esophagitis and the relevant morphometry data. Conclusions: DIS may be efficiently assessed during light microscopy of routine esophageal biopsies. Since correlation with both the histology and the symptoms of esophagitis, the DIS score may be considered a novel parameter of esophagitis and is suggested for the routine evaluation of esophageal biopsies in patients with reflux disease.
© 2001 S. Karger AG, Basel
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