Screening of endoscopic microerosions in non-erosive esophagitis by high-definition digestive endoscopy coupled with narrow-band imaging and microerosions analysis by immunohistochemical, pHmetric and histology

Abstract

Introduction: Gastroesophageal reflux disease (GERD) is considered one of the most prevalent digestive diseases in Western countries. In many cases, the symptomatic GERD is linked to a normal upper gastrointestinal endoscopy and new endoscopic techniques to identify the abnormalities are need. The high-definition digestive endoscopy coupled with narrow band imaging (NBI) could achieve a more detailed mucosal evaluation, allowing the identification of distal esophageal microerosions. Objectives: To validate the presence of distal esophageal microerosions as found in high-definition endoscopy with NBI and the associative pHmetry, histological, immunohistochemical findings of tissue specimens obtained from esophageal biopsies of patients with typical symptoms of GERD. Methods: A total of 70 participants were enrolled in a prospective, descriptive and cross-sectional study from a gastroenterology outpatient clinic. Endoscopic evaluation was sequentially performed after the pHmetry. Esophageal mucosal biopsies were obtained to perform the histological and immunohistochemical analysis. Results: From 70 participants, 30/70 (42.9%) showed mucosal microerosions. Both, pHmetry and histologic score for esophageal mucosa did not showed difference between participants with or without endoscopic microerosions. The quantitative cellular evaluation by immunohistochemistry of the esophageal mucosa was performed in 56/70 (80%) participants, which 27/56 (48.21%) showed microerosions. Also, no difference occurred between participants with or without endoscopic microerosions regarding total number of cells immunolabelled and number of cells per tissue area. Conclusions: No difference occurred between the groups of participants with typical symptoms of GERD and with or without esophageal microerosions screened by high-definition digestive endoscopy coupled with NBI regarding pHmetric, histological and immunohistochemical analysis.