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

Background. Dilation of intercellular space diameters of oesophageal epithelium detected at transmission electron microscopy morphometryis a marker of tissue injury in non-erosive reflux disease patients. Semi-quantitative evaluation of intercellular space diameters using lightmicroscopy seems to provide promising results.Aim/methods. To comparatively evaluate intercellular space diameters in the same patients, by means of morphometry and semi-quantitativeanalysis, both on light microscopy and transmission electron microscopy microphotographs, biopsies were taken in 29 non-erosive refluxdisease 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 valuesof patients, at distal and proximal oesophagus, 3- and 2-fold, respectively, higher than those in controls (p < 0.001). On light microscopymicrophotographs, mean intercellular space diameter values of patients at distal oesophagus were higher than those in controls, an overlapbetween patients and controls being observed. The semi-quantitative score was positive in 79% of patients and in 25% of controls at distalesophagus.Conclusions. Intercellular space diameter morphometric analysis at light microscopy is widely available, allows intercellular space diameterto 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 transmissionelectron microscopy- and light microscopy-morphometry.