Changes in the esophageal mucosa of patients with non erosive reflux disease: How far have we gone?

Table 2 Histological score applied by Savarino et al[7]

Criterion	Definition and method of assessment	Severity score
	(magnification)
Basal cell hyperplasia	Measure basal cell layer in μm and express as a proportion of total epithelial thickness (× 10)	0 (absent < 15%), 1 (15%-30%), 2 (> 30%). Z line 1 (> 20%)
Papillary elongation	Measure papillary length in μm and express as a proportion (%) of total epithelial thickness	0 (absent < 50%), 1 (50%-75%), 2 (> 75%) Z line 1 (> 66%)
Dilated intercellular spaces	Include irregular round dilations or diffuse widening of the intercellular space (× 40)	0 ( ≤ 5 small), 1 (≥ 6 small and ≤ 5 large) 2 (≥ 6 large)
	Small intercellular space= diameter < 1 lymphocyte
	Large intercellular spaces= diameter ≥ 1 lymphocyte
Intraepithelial	Count cells in the most affected power field (× 40)	0 (0 cells in one high power field)
eosinophils		1 (1 cell), 2 (> 1 cells)
Intraepithelial neutrophils	Count cells in the most affected power field (× 40)	0 (absent), 2 (present)
Erosions/necrosis	Assess as presence of at least one of the following: necrosis, granulation tissue or fibrin within neutrophils (× 10)	0 (absent), 2 (present)
Combined severity score	Sum of lesion severity scores divided by the number of lesions assessed. Erosions/necrosis are not counted for the global score
	Positive for microscopic esophagitis when the value was ≥ 0.35

Biopsies were taken from the squamous epithelium side of the squamocolumnar junction and at 2 cm above it.