Dilated intercellular spaces in subtypes of gastroesophagic reflux disease.
BACKGROUND
Dilatation of the intercellular spaces by electron microscopy has been considered as an early morphological marker of tissue injury in gastroesophageal reflux disease. The degree of dilatation in Barret's esophagus in currently unknown.


OBJECTIVE
To determine the frequency of dilated intervellular spaces in Barrett's esophagus.


METHODS
Cross-sectional and prospective analysis of consecutive patients with gastroesophageal reflux disease. We selected symptomatic patients > 18 years and both sexes. Patients with recent PPI use (< 14 days), H-2 antagonists, NSAID's or previous upper GI tract surgery were excluded. VARIABLES INCLUDED: Clinical-demographic data, Carlsson-Dent score, conventional endoscopy findings, pH-metry results (in non-erosive) and normal mucosal biopsies at 2 and 5 cm above the squamocolumnar junction. Dilation of intercellular spaces was measured by electron microscopy.


METHODS
Chi square test with a significance level 0.05 was calculated. The following four groups were compared: a) non-erosive reflux disease (n = 14); b) erosive esophagitis (n = 5); c) Barrett's esophagus (n = 13); and d) healthy controls (n = 5).


RESULTS
the dilation of intervellular spaces was increasingly greater form non-erosive revlux to Barrett's esophagus and higher in biopsies taken at 5 cm than at 2 cm of the squamous columnar junction (2.72 +/- 1.35 vs. 1.71 +/- 0.48 microg) (p = 0.001). There was no difference between biopsies at 2 and 5 cm in the order groups.


CONCLUSIONS
dilation of intercellular spaces was greater in Barrett s esophagus than in the other groups and higher at 5 cm from the squamocolumnar junction.
Alvaro-Villegas
J C
JC
Services of Endoscopy, Instituto Nacional de Cancerología, Hospital General Dr Manuel Gea González, México. jc_alvarov@hotmail.com
Sobrino-Cossío
S
S
Hernández-Guerrero
A
A
Alonso-Lárraga
J O
JO
de-la-Mora-Levy
J G
JG
Molina-Cruz
A
A
Domínguez-Malagón
H R
HR
Herrera-Esquivel
J J
JJ
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology; D001706:Biopsy; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000145:classification* / Q000473:pathology*; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011446:Prospective Studies