Intercellular space diameters of the oesophageal epithelium in NERD patients: Head to head comparison between light and electron microscopy analysis

• Published in: Digestive and liver disease 2009-01, Vol.41 (1), p.9-14
• Main Authors: Ribolsi, M, Perrone, G, Caviglia, R, Gentile, M, Emerenziani, S, Luca Guarino, M.P, Petitti, T, Cicala, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers; Case-Control Studies; Dilated intercellular spaces; Epithelium - pathology; Epithelium - ultrastructure; Esophageal pH Monitoring; Esophagoscopy; Esophagus - pathology; Esophagus - ultrastructure; Extracellular Space; Female; Gastroenterology and Hepatology; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - pathology; Humans; Image Processing, Computer-Assisted; Light microscopy; Male; Manometry; Microscopy - methods; Microscopy, Electron; Middle Aged; NERD; Transmission electron microscopy; Young Adult
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2008.07.318

Abstract Background Dilation of intercellular space diameters of oesophageal epithelium detected at transmission electron microscopy morphometry is a marker of tissue injury in non-erosive reflux disease patients. Semi-quantitative evaluation of intercellular space diameters using light microscopy seems to provide promising results. Aim/methods To comparatively evaluate intercellular space diameters in the same patients, by means of morphometry and semi-quantitative analysis, both on light microscopy and transmission electron microscopy microphotographs, biopsies were taken in 29 non-erosive reflux disease patients at distal and proximal oesophagus. Twelve asymptomatic controls underwent the same protocol. Results Morphometric analysis on transmission electron microscopy microphotographs showed mean intercellular space diameter values of patients, at distal and proximal oesophagus, 3- and 2-fold, respectively, higher than those in controls ( p < 0.001). On light microscopy microphotographs, mean intercellular space diameter values of patients at distal oesophagus were higher than those in controls, an overlap between patients and controls being observed. The semi-quantitative score was positive in 79% of patients and in 25% of controls at distal esophagus. Conclusions Intercellular space diameter morphometric analysis at light microscopy is widely available, allows intercellular space diameter to be quantitatively measured with good sensitivity and specificity and could represent a useful tool in non-erosive reflux disease diagnosis. Despite satisfactory sensitivity, the semi-quantitative score at light microscopy is hampered by much lower specificity than transmission electron microscopy- and light microscopy-morphometry.