Vanderbilt University Medical Center, Nashville, TN 37232-5280, USA.
Aliment Pharmacol Ther. 2010 Oct;32(7):916-24. doi: 10.1111/j.1365-2036.2010.04420.x.
Dilation of intercellular spaces is reported to be an early morphological marker in gastro-oesophageal reflux. It remains unknown if this marker is useful in diagnosing reflux-related chronic laryngitis.
To determine histopathology and electron microscopic changes in oesophageal and laryngeal epithelium in chronic laryngitis.
In this prospective blinded study, we enrolled 53 participants: 15 controls, 20 patients with GERD and 18 patients with chronic laryngitis. The latter two groups were subsequently treated with lansoprazole 30 mg bid for 12-weeks. Baseline and postacid suppressive therapy biopsies were obtained from distal oesophagus and laryngeal postcricoid areas. Biopsy specimens were evaluated for histopathology and dilated intercellular space changes.
There was no significant increase in oesophageal or laryngeal epithelium intercellular spaces among GERD or laryngitis patients compared with controls at baseline or postacid suppressive therapy. Only patients with GERD had significantly (P = 0.03) higher proportion of moderate-to-severe oesophageal spongiosis and basal cell hyperplasia, which normalized postacid suppressive therapy.
There was no increase in the width of intercellular spaces in the oesophagus or larynx in GERD or chronic laryngitis at baseline or postacid suppressive therapy. Our findings question the uniform presence of dilated intercellular space in patients with GERD.
细胞间隙扩张被报道为胃食管反流的早期形态学标志物。目前尚不清楚该标志物是否可用于诊断与反流相关的慢性喉炎。
确定慢性喉炎中食管和喉上皮的组织病理学和电子显微镜变化。
在这项前瞻性、双盲研究中，我们纳入了 53 名参与者：15 名对照组、20 名 GERD 患者和 18 名慢性喉炎患者。后两组随后接受兰索拉唑 30mg bid 治疗 12 周。在基线和抑酸治疗后，从远端食管和喉环状软骨后区获取活检标本。评估活检标本的组织病理学和细胞间隙扩张变化。
与对照组相比，GERD 或喉炎患者的食管或喉上皮细胞间隙在基线或抑酸治疗后均无明显增加。只有 GERD 患者的食管中度至重度海绵状变和基底细胞增生显著增加（P = 0.03），抑酸治疗后恢复正常。
在基线或抑酸治疗后，GERD 或慢性喉炎患者的食管或喉细胞间隙宽度均无增加。我们的研究结果质疑 GERD 患者普遍存在细胞间隙扩张的假设。
