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Scanning Microscopy

Abstract

The purpose of this review on state-of-the-art and new perspectives on the use of scanning electron microscopy (SEM) in gastrointestinal pathology is to discuss the possibility of developing an index for quantitatively grading mucosal epithelial injury. This topic is reviewed within the framework of ulcer indices previously developed for gross lesions, where analogous problems exist, and in relation to the transmission electron microscope staging of epithelial cell pathology. If such an index could be developed it would increase objectivity and standardization of data analysis from laboratory to laboratory, and would allow for quantitative and statistical analysis of morphometric data. It is concluded that an index is possible based upon fields of injured cells rather than upon the grading of individual cell injury progression. An example of a useful SEM lesion index is presented. There are definite limitations to development of such an index, and guidelines are provided to help minimize some of the numerous complicating factors. These guidelines include comments on magnification, tissue contour, cell versus tissue analysis, morphometric considerations, sources of error, and other factors.

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