Dilated intercellular spaces as markers of reflux disease: Histology, semiquantitative score and morphometry upon light microscopy

Background and Aims: A recent electron microscopy study suggested that dila ted intercellular spaces (DIS) are specific for acid reflux-damaged esophag eal epithelium. Electron microscopy is, however, expensive and difficult to apply to routine biopsies. The aims of this study are to establish a metho d for assessing DIS on light microscopy of esophageal biopsies and to estim ate its association with current clinicopathological parameters of esophagi tis. Materials and Methods: 21 patients with reflux symptoms were investiga ted. Light microscopy biopsies were assessed for DIS size by a semiquantita tive method and computer-assisted, static morphometry. A DIS score accounti ng for DIS size and distribution was assigned to each patient and its assoc iation with 30 clinicopathological variables investigated by univariate and multivariate logistic regression. Results: Both the semiquantitative metho d and static morphometry identified 4 different classes of DIS size. The DI S score was significantly and independently associated with the esophageal symptoms score, the histological score of esophagitis and the relevant morp hometry data. Conclusions: DIS may be efficiently assessed during light mic roscopy of routine esophageal biopsies. Since correlation with both the his tology and the symptoms of esophagitis, the DIS score may be considered a n ovel parameter of esophagitis and is suggested for the routine evaluation o f esophageal biopsies in patients with reflux disease. Copyright (C) 2001 S . Karger AG, Basel.