Histological changes in the oesophageal squamous mucosa: correlation with ambulatory 24 hour pH monitoring.
OBJECTIVE
To determine the value of squamous mucosal histology in the assessment of patients with gastro-oesophageal reflux symptoms.


METHODS
Sixty six patients with reflux symptoms underwent endoscopy with oesophageal biopsy, manometry, and 24 hour oesophageal pH testing. The following histological features were assessed in squamous mucosa: the degree of basal cell hyperplasia, the degree of papillary zone elongation, and the density of neutrophil and eosinophil infiltration. Comparisons were made between the histological findings and the oesophageal function tests.


RESULTS
The correlation between the traditionally accepted histological markers of gastro-oesophageal reflux disease in squamous mucosa and 24 hour pH testing was predominantly negative, with the exception of neutrophil inflammation in the squamous mucosa of patients with complicated reflux disease.


CONCLUSIONS
This study was unable to confirm the value of the Ismail-Beigi criteria as histological markers of acid reflux. By inference, biopsy of the oesophageal squamous mucosa is of limited value in the assessment of patients with reflux symptoms.
Bowrey
D J
DJ
Department of Surgery, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK. bowrey@dialstart.net
Williams
G T
GT
Clark
G W B
GW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D004941:Esophagitis / Q000378:metabolism / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006965:Hyperplasia / Q000473:pathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D009092:Mucous Membrane / Q000473:pathology; D020556:Neutrophil Infiltration