Topographical variation in the mucosal surface of oesophageal biopsies.

There have been comparatively few scanning electron microscopic (SEM) studies of mucosal biopsies of the human upper gastrointestinal tract. This study reviews the use of SEM in human oesophageal research and deals with the results of a SEM study of thirty two biopsies of human oesophagus, taken from eighteen patients during endoscopy for upper gastrointestinal symptoms. For each biopsy, three areas of the mucosal surface chosen at random were examined using standard magnifications. The SEM showed three mucosal patterns, which were designated typical squamous, atypical squamous and nonsquamous, each displaying common features in relation to desquamation, cell boundaries and microridges. The two squamous epithelial groups showed surface microridges. The typical group displayed clear cut cell boundaries and well developed microridges arranged in rows. The atypical squamous group showed desquamation, less well developed cell boundaries and variation in microridge patterns. Many nonsquamous specimens displayed simple columnar epithelium, similar to mucosa of gastric type. Care was taken to correlate the surface structure of the oesophagus with the endoscopic appearance. The two assessments were done independently and the material was coded throughout. The broad subdivision of the biopsies into groups using these qualitative topographical criteria gave good correspondence with the endoscopic appearance.