Sakal V. Optimization of pathology-anatomical diagnosis of gastroesophageal reflux disease

The work is aimed at investigation and improvement of the quality of diagnostic measures of pathological processes of the esophagus in the presence of gastroesophageal reflux disease (GERD). The bioptates of the esophagus of 223 patients with GERD (72 women and 151 men aged 22-80) were investigated. In accordance with the clinical and endoscopic classification adopted at the IX European Gastroenterology Week in Amsterdam, after comparing endoscopic and histological findings the material was distributed into three groups: 1) non-erosive GERD, 104 cases or 46.64%; 2) erosive and ulcerative form, 77 patients, 34.53%; 3), Barrett's esophagus, which was revealed in 42 patients (18.83%). The work allowed to obtaine reliable indicators characterizing the features of morphogenesis of various forms of GERD. Risk factors for erosive esophagitis and its complications were identified. Scientific evidence of such morphological signs of GERD as the degree of basal layer hyperplasia, elongation of epithelial papillae, the degree of infiltration with lymphocytes and leukocytes, the presence of erosive and/or ulcerative changes, the presence of metaplasia and dysplasia were refined. For the first time, disorders of endothelial and inducible fractions of nitric oxide as one of the chains of esophageal damage in GERD were investigated. Scientific concepts about the dynamics of pathological changes in the esophagus in GERD, especially necrobiotic, proliferative, dysplastic changes and metaplasia of the esophageal epithelium as well as apoptosis were expanded. The relationship of changes of esophageal mucosa of the stomach and chronic atrophic (atrophic-hyperplastic) gastritis in GERD was confirmed. Clinical-instrumental and morphological parallels identified in patients with GERD can be used at development of new prevention methods and improved of treatment for GERD.