Objective To explore the diagnostic value of dilated intercellular space detected by light microscope for non-erosive reflux disease (NERD) and erosive esophagitis (RE). Methods A total of 104 subjects were divided into normal control group (n = 20), NERD group (n = 30) and RE group (n = 54).Biopsies were taken at 2-3 cm above the dentate line and were examined by light microscope to calculate the intercellular space and compared between different groups. Results The mean values of intercellular space in RE ( 1.40 ±0. 17 μm) and NERD ( 1.11 ± 0. 14 μm) were significantly higher than that in control group (0.66±0. 18 μm, x2 = 154. 170, P =0.000). But no significant difference was noted between RE and NERD groups ( t = 0. 044, P = 0. 834). The cut-off value of mean intercellular space with light microscope was 0. 89 μm, with sensitivity and specificity at 95.2% and 95.0%, respectively. Conclusion Dilated intercellular space under light microscope can be a sensitive, specific and objective indicator of NERD.%目的 探讨光学显微镜下观察食管远端黏膜上皮细胞间隙的增宽对非糜烂性反流病(NERD)和糜烂性食管炎(RE)患者的诊断价值.方法 104例受试者分为正常对照组20例、NERD组30例和RE组54例;在齿状线上2～3 cm取活检行光镜检查,观察黏膜上皮细胞间隙是否增宽并对其进行统计学分析.结果 RE组和NERD组平均细胞间隙分别为(1.40±0.17)μm、(1.11±0.14)μm与正常对照组(0.66±0.18)μm比较,差异均有统计学意义(x2=154.170,P=0.000),而RE组和NERD组间差异无统计学意义(t=0.044,P=0.834).光镜下平均细胞间隙的截断(cut-off)值为0.89 μm,光镜下平均细胞间隙诊断GERD的敏感度为95.2%,特异度为95.0%.结论 光镜下黏膜上皮细胞间隙增宽可作为NERD诊断的敏感、特异且较为客观的指标.
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