Comparison of fiberoptic endoscope and Quinton tube human gastric biopsies.

Morphological examination of human gastric mucosa is being increasingly reported with the widespread use of upper gastrointestinal endoscopy. To our knowledge no studies have been reported comparing gastric mucosal tissue obtained with pinch biopsies through the endoscope with those taken by the Quinton hydraulic biopsy instrument for light and electron microscopic examination. We report such a study. Gastric biopsies were obtained from healthy volunteers. Gastric biopsies taken with the Quinton hydraulic tube have a number of distinct advantages over those taken with the standard pinch biopsy forceps. These relate primarily to the size, shape and depth of the specimens obtained. Quinton samples are large (2-3 mm in diameter), flat, discshaped specimens which are relatively free of contaminating debris on the mucosal surface. Because of their disc shape, Quinton biopsies are easily orientated for light microscopy. 55 percent of all Quinton biopsies contained muscularis mucosae. In contrast, samples taken by the standard forceps method are small (0.5--1 mm in diameter), have a tendency to roll-up into a ball, and show considerable surface debris making scanning electron microscopy of the mucosa difficult. Consistent orientation of the surface epithelium for light microscopy is more difficult with the pinch biopsies because of the small size and irregular shape of the samples. Crushing and tearing artifacts at the periphery of biopsy specimens are common. Light microscopic sections of forceps' biopsies provide a mean +/- SE of only 227 +/- 17 consecutive surface cells for examination compared to 730 +/- 24 (p less than 0.001) for Quinton biopsies. Only 7% of all pinch biopsies included muscularis mucosae.(ABSTRACT TRUNCATED AT 250 WORDS)