Spence R A, Sloan J M, Johnston G W, Greenfield A
Gut. 1983 Nov;24(11):1024-9. doi: 10.1136/gut.24.11.1024.
Histological examination of oesophageal rings removed at transection for varices reveals dilated intraepithelial blood filled channels. These are present in all oesophageal rings removed at transection for varices. A comparison has been made between rings removed from variceal patients with oesophageal rings removed during resections for oesophageal and gastric tumours. Although a small number of non-varices patients had intraepithelial channels they were significantly larger and more numerous in the varices patients (p less than 0.01). Similarly, the area and number of dilated subepithelial channels (just beneath the epithelium) and the area of lamina propria channels were significantly greater in the varices patients (p less than 0.05). Depth of papillae and thickness of the squamous epithelium were also significantly greater in the varices group (p less than 0.05, p less than 0.01 respectively). Under electron microscopy the channels were lined with flattened cells which were not typical of endothelial cells but stained positively for Factor VIII related antigen using indirect immunofluorescence. These channels may correspond to the cherry-red spots seen on endoscopy and may have a role in the pathogenesis of variceal haemorrhage.
对因静脉曲张而在横断切除时取下的食管环进行组织学检查，发现上皮内有扩张的充满血液的通道。这些通道存在于所有因静脉曲张而在横断切除时取下的食管环中。已对从静脉曲张患者取下的环与在食管和胃肿瘤切除术中取下的食管环进行了比较。虽然少数非静脉曲张患者有上皮内通道，但在静脉曲张患者中这些通道明显更大且更多（p小于0.01）。同样，在静脉曲张患者中，扩张的上皮下通道（恰在上皮下方）的面积和数量以及固有层通道的面积也明显更大（p小于0.05）。静脉曲张组乳头的深度和鳞状上皮的厚度也明显更大（分别为p小于0.05，p小于0.01）。在电子显微镜下，这些通道内衬扁平细胞，这些细胞不是典型的内皮细胞，但用间接免疫荧光法对VIII因子相关抗原呈阳性染色。这些通道可能与内镜检查时看到的樱桃红点相对应，并且可能在静脉曲张出血的发病机制中起作用。
