Esophageal Histopathology in Patients with Typical and Atypical Symptoms of Gastroesophageal Reflux Disease. Comparative Study with Healthy Volunteers

Resumo

The aim of this study was to investigate the histological findings in the superior, middle and inferior thirds of the esophagus of the patients porters with gastroesophageal reflux disease (GERD) that present typical and atypical symptoms as compared to volunteers without clinical manifestation of GERD. It was accomplished a prospective and longitudinal study with 30 individuals submitted to 24-hour esophageal pHmetry testing in private clinic. Among them, 20 patients presented GERD diagnostic and 10 patients presented negative results for GERD. The patients were distributed in 3 groups: Typical Reflux Group (Group I) with 10 patients with typical symptoms of GERD; Atypical Reflux Group (Group II) with10 patients with atypical symptoms of GERD; and Asymptomatic Group (Group III): 10 volunteers without clinical manifestation of GERD. Each group was formed with 5 men and 5 women. In all patients was accomplished a esophagogastroduodenoscopy with biopsy of the superior, middle and inferior thirds of the esophagus, totalizing 3 biopsies for each patient with histological material analysis. The criteria studied were the basal cell hyperplasia, papillary zone elongation, neutrophil and eosinophil infiltration, vascular congestion and hemorrhage. The collected data were submitted to a statistics analysis by ANOVA using Bioestat© 5.0 program. The only criterion that had meaningful difference was the basal cell hyperplasia, which was more prevalent in the inferior third than the superior and middle thirds of the esophagus, for all groups. The comparative histological analysis showed only statistical differences in the inferior third of esophagus, where a significant basal layer hyperplasia was evidenced.