Dilated intercellular spaces: A morphological feature of acid reflux-damaged human esophageal epithelium
Dilated intercellular spaces: A morphological feature of acid reflux-damaged human esophageal epithelium
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DOI：
10.1053/gast.1996.v111.pm8898633
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发表时间：
1996-11-01
期刊：
影响因子：
29.4
通讯作者：
Orlando, RC
中科院分区：
文献类型：
--
作者：
Tobey, NA;Carson, JL;Orlando, RC
背景和目标：扩张的细胞间隙是酸灌注兔食管上皮损伤的标志，这种变化最好通过透射电子显微镜鉴定。本研究的目的是确定这种变化是否也是人类食管上皮酸损伤的一个特征。研究方法：采用透射电子显微镜检查了11例和13例复发性胃灼热患者的内镜食管活检标本。在11例胃灼热患者中，6例糜烂性食管炎，5例内镜下粘膜正常; 13例对照组无食管疾病症状或体征。使用计算机，细胞间隙直径从每个患者的标本的透射电子显微镜照片测量。结果如下：胃灼热患者的标本中细胞间隙直径显著大于对照组;无论患者是否患有糜烂性或非糜烂性疾病，这都是正确的。大于或等于2.4 μ m的空间直径存在于11例胃灼热患者中的8例中，而对照组中没有。结论：细胞间隙扩张是反流损伤食管上皮的一个特征。作为细胞旁通透性增加的形态学标志物，它在没有内镜异常的患者中的存在可能有助于解释他们胃灼热的发展。
Background & Aims: Dilated intercellular spaces are a sign of epithelial damage in acid-perfused rabbit esophagus, a change best identified by transmission electron microscopy. The aim of this study was to determine if this change is also a feature of acid damage to human esophageal epithelium. Methods: Endoscopic esophageal biopsy specimens from patients with (n = 11) and without (n = 13) recurrent heartburn were examined using transmission electron microscopy. Of 11 patients with heartburn, 6 had erosive esophagitis and 5 had normal-appearing mucosa on endoscopy; 13 controls had no symptoms or signs of esophageal disease. Using a computer, intercellular space diameter was measured from transmission electron microscopy photomicrographs of the specimen from each patient. Results: Intercellular space diameter was significantly greater in specimens from patients with heartburn than those from controls; this was true irrespective of whether the patient had erosive or nonerosive disease. Space diameters of greater than or equal to 2.4 mu m were present in 8 of 11 patients with heartburn and in no controls. Conclusions: Dilated intercellular spaces are a feature of reflux damage to human esophageal epithelium. As a morphological marker of increased paracellular permeability, its presence in patients without endoscopic abnormalities may help explain their development of heartburn.