Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 14, Number 4, August 2021, pages 220-226

Usefulness of the Eosinophilic Esophagitis Histologic Scoring System in Distinguishing Active Eosinophilic Esophagitis From Remission and Gastroesophageal Reflux Disease

Figure 1. Total grade scores (a) and total stage scores (b) in patients with gastroesophageal reflux disease (GERD), active eosinophilic esophagitis (EoE-A) and eosinophilic esophagitis in remission (EoE-R) in distal and mid esophagus. Horizontal lines above the bars show the groups that were compared and had a significant difference (P < 0.05).

Figure 2. Total grade scores (a) and total stage scores (b) in patients with gastroesophageal reflux disease (GERD), active eosinophilic esophagitis (EoE-A) relative to PEC (high (EoE-A-H), moderate (EoE-A-M), low (EoE-A-L)) and eosinophilic esophagitis in remission (EoE-R). Horizontal lines above the bars show the groups that were compared and had a significant difference (P < 0.05).

Figure 3. Mean grade scores (a) and mean stage scores (b) of basal zone hyperplasia (BZH), dilated intercellular space (DIS), lamina propria fibrosis (LPF) and peak eosinophil count (PEC) in mid and distal esophagus of patients with EoE-A. Horizontal lines above the bars show the groups that were compared and had a significant difference (P < 0.05).

**Table 1.** Characteristics of Patients With GERD, EoE-A and EoE-R
	Patient groups
hpf: high-power field; PEC: peak eosinophil count; SEM: standard error of mean; GERD: gastroesophageal reflux disease; EoE-A: active eosinophilic esophagitis; EoE-R: eosinophilic esophagitis in remission.
Age, median (range), years	11 (1 - 21)	9.5 (1 - 20)	10.5 (2 - 21)
Gender
Male	21	29	10
Female	16	7	2
PEC/hpf, mean ± 1 SEM	0.5 ± 0.24	66 ± 6.7	1.5 ± 0.7

Table 1. Characteristics of Patients With GERD, EoE-A and EoE-R

Patient groups

GERD (n = 37)

EoE-A (n = 36)

EoE-R (n = 12)

hpf: high-power field; PEC: peak eosinophil count; SEM: standard error of mean; GERD: gastroesophageal reflux disease; EoE-A: active eosinophilic esophagitis; EoE-R: eosinophilic esophagitis in remission.

Age, median (range), years

11 (1 - 21)

9.5 (1 - 20)

10.5 (2 - 21)

Gender

Male

Female

PEC/hpf, mean ± 1 SEM

0.5 ± 0.24

66 ± 6.7

1.5 ± 0.7

**Table 2.** Mean Grade and Stage Scores of Histologic Features of Patients With GERD, EoE-A and EoE-R
Histologic feature	Patient groups
Data are expressed as mean ± 1 SEM. hpf: high-power field; SEM: standard error of mean; GERD: gastroesophageal reflux disease; EoE-A: active eosinophilic esophagitis; EoE-R: eosinophilic esophagitis in remission.
Peak eosinophil count/hpf	1 ± 0	0	2.2 ± 0.09	2.2 ± 0.11	1 ± 0	0
Basal zone hyperplasia	0.0 ± 0.03	0.1 ± 0.03	2.1 ± 0.12	2.3 ± 0.13	0.25 ± 0.09	0.5 ± 0.18
Eosinophil abscesses	0	0	0.8 ± 0.13	0.8 ± 0.12	0	0
Eosinophil surface layering	0	0	0.8 ± 0.13	0.8 ± 0.12	0	0
Dilated intercellular spaces	1.1 ± 0.04	1 ± 0	2.5 ± 0.07	2.4 ± 0.08	1.3 ± 0.09	1.1 ± 0.06
Surface epithelial alteration	0	0	0.8 ± 0.14	0.8 ± 0.13	0	0
Dyskeratotic epithelial cells	0	0	0.1 ± 0.04	0.04 ± 0.02	0	0
Lamina propria fibrosis	0.1 ± 0.04	0.2 ± 0.12	1.6 ± 0.16	1.5 ± 0.15	0.5 ± 0.1	1 ± 0.58

Table 2. Mean Grade and Stage Scores of Histologic Features of Patients With GERD, EoE-A and EoE-R

Histologic feature

Patient groups

GERD (n = 37)

EoE-A (n = 36)

EoE-R (n = 12)

Grade

Stage

Grade

Stage

Grade

Stage

Data are expressed as mean ± 1 SEM. hpf: high-power field; SEM: standard error of mean; GERD: gastroesophageal reflux disease; EoE-A: active eosinophilic esophagitis; EoE-R: eosinophilic esophagitis in remission.

Peak eosinophil count/hpf

1 ± 0

2.2 ± 0.09

2.2 ± 0.11

1 ± 0

Basal zone hyperplasia

0.0 ± 0.03

0.1 ± 0.03

2.1 ± 0.12

2.3 ± 0.13

0.25 ± 0.09

0.5 ± 0.18

Eosinophil abscesses

0.8 ± 0.13

0.8 ± 0.12

Eosinophil surface layering

0.8 ± 0.13

0.8 ± 0.12

Dilated intercellular spaces

1.1 ± 0.04

1 ± 0

2.5 ± 0.07

2.4 ± 0.08

1.3 ± 0.09

1.1 ± 0.06

Surface epithelial alteration

0.8 ± 0.14

0.8 ± 0.13

Dyskeratotic epithelial cells

0.1 ± 0.04

0.04 ± 0.02

Lamina propria fibrosis

0.1 ± 0.04

0.2 ± 0.12

1.6 ± 0.16

1.5 ± 0.15

0.5 ± 0.1

1 ± 0.58

**Table 3.** Grade and Stage Scores of Histologic Features for Mid and Distal Esophageal Regions in EoE-A Patients
	Distal = Mid	Distal > Mid	Distal < Mid
Data are expressed as n (%). EoE-A: active eosinophilic esophagitis.
Grade score	18 (50%)	12 (33.3%)	6 (16.7%)
Stage score	16 (44.4%)	12 (33.3%)	8 (22.2%)

Table 3. Grade and Stage Scores of Histologic Features for Mid and Distal Esophageal Regions in EoE-A Patients

Distal = Mid

Distal > Mid

Distal < Mid

Data are expressed as n (%). EoE-A: active eosinophilic esophagitis.

Grade score

18 (50%)

12 (33.3%)

6 (16.7%)

Stage score

16 (44.4%)

12 (33.3%)

8 (22.2%)