title: Subclassification of superficial cardia cancer in relation to the endoscopic esophagogastric junction.
abstract: BACKGROUND
  The incidence of adenocarcinoma of the gastric cardia has been reported to be increasing, but the endoscopic characteristics of the mucosal background of the tumor remain unclear. The purpose of the present study was to evaluate the relationship between the location of the adenocarcinoma according to the esophagogastric junction (EGJ) and mucosal characteristics.
  
  
  METHODS
  Patients with superficial adenocarcinoma of the gastric cardia diagnosed pathologically were enrolled and divided into the above-EGJ group and the below-EGJ group according to tumor location. The EGJ was judged as the lower end of the esophageal longitudinal vessels. We retrospectively reviewed endoscopic findings with respect to the classification of reflux esophagitis, hiatus hernia, valvular appearance of the cardia and the pattern of atrophic gastritis.
  
  
  RESULTS
  The incidence of reflux esophagitis in the above-EGJ group and below-EGJ group was 75.0% and 30.0%, respectively. The severity of hiatus hernia and the valvular appearance of the cardia of patients in the above-EGJ group were worse than in the patients in the below-EGJ group. The pattern of atrophic gastritis in the patients in the above-EGJ group was the closed type, whereas patients in the below-EGJ group had the open type.
  
  
  CONCLUSIONS
  There were significant differences between cancers above or below the EGJ, so classification of adenocarcinoma of the gastric cardia according to location is recommended.
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Longxue
authors.initials: L
authors.lastname: Jin
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Norihito
authors.initials: N
authors.lastname: Wada
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumai
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kubota
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology*; D002299:Cardia / Q000473:pathology*; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D004942:Esophagitis, Peptic / Q000473:pathology; D004943:Esophagogastric Junction; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000473:pathology; D006551:Hernia, Hiatal / Q000473:pathology; D006801:Humans; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000145:classification / Q000473:pathology*