Abstract

ALVARO-VILLEGAS, J. C. et al. Dilated intercellular spaces in subtypes of gastroesophagic reflux disease. Rev. esp. enferm. dig. [online]. 2010, vol.102, n.5, pp.302-307. ISSN 1130-0108.

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 Barrett's esophagus is currently unknown. Objectives: to determine the frequency of dilated intercellular spaces in Barrett's esophagus. Material and 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. Statistics: 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 intercellular spaces was increasingly greater from non-erosive reflux to Barret'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 μm) (p = 0.001). There was no difference between biopsies at 2 and 5 cm in the other groups. Conclusion: dilation of intercellular spaces was greater in Barrett's esophagus than in the other groups and higher at 5 cm from the squamocolumnar junction.

Keywords : Erosive esophagitis; Barrett's esophagus; Dilated intercellular spaces; Gastroesophageal reflux disease.

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