[Evaluation by endoscopic biopsies, of the histological criteria of reflux esophagitis].

Histologic criteria of esophagitis and/or gastroesophageal reflux have been described in suction biopsy specimens which are easy to orient for perpendicular section of the mucosal surface. The aim of this study was to reassess the currently accepted criteria in guided endoscopic pinch biopsy specimens obtained from esophageal erosions. Epithelium of each sample was stained by Lugol's solution in order to be able to spread the specimen out flat and orient it before fixation. Of 92 biopsies nine were composed of granulation tissue and were excluded from the study. Of the remaining 83 biopsy specimens, 74 (89.2 p. 100) from 66 patients were properly oriented. Of these 74.65 (87.8 p. 100) from 57 patients contained lamina propria. Combination of the 2 epithelial criteria, i.e. papillary height and basal cell zone thickness greater than 50 p. 100 and 14 p. 100 of total epithelial thickness, respectively, were recorded in only 58 p. 100 of 66 patients. Nevertheless, the mean papillary height and the mean basal cell layer thickness were 64 p. 100 and 19 p. 100 of total epithelial thickness, respectively. Infiltration of the lamina propria by neutrophilic and/or eosinophilic granulocytes were recorded in 32 of 57 patients (56 p. 100) and only in 48 p. 100 of biopsy specimens which did not display any epithelial defect. Combination of pathologic changes in epithelium and lamina propria were observed in only 32 p. 100 of the patients and were not more frequent than expected on the basis of a chance association. We conclude that histologic criteria have a low sensitivity even in patients with erosive esophagitis.(ABSTRACT TRUNCATED AT 250 WORDS)