Summary
Objective
It was hypothesized that typical characteristics of hyperregeneratory esophagopathy
(HRE) in humans such as basal cell hyperplasia and elongation of stromal papillae
are also histologically detectable in canine esophageal epithelium, and that these
changes are associated with clinical signs and endoscopic findings suggesting gastroesophageal
reflux (GER).
Material and methods
Sixty-five adult dogs with clinical signs attributable to esophageal disease underwent
esophagoscopy and biopsy. Clinical signs suggesting GER (regurgitation, ptyalism,
painful discomfort) were prospectively evaluated through a questionnaire. Endoscopic
mucosal alterations suggesting GER such as minimal endoscopic changes and obvious
mucosal defects were assessed via video endoscopy. Biopsy specimens obtained from
the esophageal squamous epithelium were evaluated histologically. The squamous epithelium’s
substructures of esophageal biopsies were quantitatively assessed through microscopic
morphometry.
Results
Esophageal squamous epithelium was considered normal in 48 dogs, and HRE was detected
histologically in 17 dogs; both pathognomonic changes (basal cell hyperplasia, elongation
of stromal papillae) were consistently present. Morphometrically assessed stromal
papillary length and basal cell layer thickness was significantly (each, p < 0.0001)
higher in the 17 dogs with HRE than in the 48 dogs without HRE, respectively. Overall,
clinical signs suggesting GER were significantly (p = 0.02) more frequently encountered
and regurgitation was significantly (p = 0.009) more common in the 17 dogs with HRE
than in the 48 dogs without HRE. Similarly, endoscopic changes were significantly
(p = 0.002) more frequently observed and minimal endoscopic changes suggesting GER
were significantly (p = 0.004) more common in 17 dogs with HRE than in the 48 dogs
without HRE.
Conclusion and clinical relevance
Typical characteristics of hyperregeneratory esophagopathy in humans are also histologically
detectable in canine esophageal epithelium. Histological changes are associated with
clinical signs and endoscopic findings suggesting GER.
Keywords
Endoscopy - morphometry - gastroesophageal reflux disease - cut off values - sensitivity
- specificity