Subclassification of superficial cardia cancer in relation to the endoscopic esophagogastric junction.
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.
Jin
Longxue
L
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Yoshida
Masashi
M
Kitagawa
Yuko
Y
Saikawa
Yoshiro
Y
Takeuchi
Hiroya
H
Wada
Norihito
N
Kumai
Koichiro
K
Kubota
Tetsuro
T
Kitajima
Masaki
M
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*