title: Two distinct types of cancer of different origin may be mixed in gastroesophageal junction adenocarcinomas in Japan: evidence from direct evaluation of gastric acid secretion.
abstract: OBJECTIVE
  Barrett's esophageal cancer is usually included in gastroesophageal (GE) junction adenocarcinoma in Japanese people. No study on the pathogenesis of Barrett's esophageal cancer in comparison with GE junction adenocarcinoma other than Barrett's esophageal cancer has been reported in Japan. The aim of this study was to evaluate the clinical and pathological characteristics and gastric acid secretion of Barrett's esophageal cancer and GE junction adenocarcinoma other than Barrett's esophageal cancer in Japanese subjects.
  
  
  METHODS
  Twenty-three patients with Barrett's esophageal cancer and 23 patients with GE junction adenocarcinoma other than Barrett's esophageal cancer were enrolled in this study. We evaluated and compared them by assessing the Helicobactor pylori (HP) infection status and gastric acid secretion using the endoscopic gastrin test (EGT).
  
  
  RESULTS
  In the patients with Barrett's esophageal cancer, no significant difference was found in the mean EGT value between HP-positive and -negative patients, but in the patients with GE junction adenocarcinoma other than Barrett's esophageal cancer, the mean EGT value in HP-positive patients was significantly lower than that in HP-negative patients.
  
  
  CONCLUSIONS
  Two distinct types of cancer of different origin may be mixed in GE junction adenocarcinomas. One is Barrett's esophageal cancer associated with high gastric acid secretion and reflux of gastric acid into the esophagus, the other is cancer resembling distal gastric cancer associated with gastric atrophy and low gastric acid secretion.
authors: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Toru
authors: T
authors: Horii
authors: Tomoyuki
authors: T
authors: Koike
authors: Yasuhiko
authors: Y
authors: Abe
authors: Ryosuke
authors: R
authors: Kikuchi
authors: Hiroyuki
authors: H
authors: Unakami
authors: Katsunori
authors: K
authors: Iijima
authors: Akira
authors: A
authors: Imatani
authors: Shuichi
authors: S
authors: Ohara
authors: Tooru
authors: T
authors: Shimosegawa
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000378:metabolism / Q000382:microbiology; D000368:Aged; D001471:Barrett Esophagus / Q000145:classification* / Q000378:metabolism / Q000382:microbiology; D016022:Case-Control Studies; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000145:classification* / Q000378:metabolism / Q000382:microbiology; D004943:Esophagogastric Junction / Q000378:metabolism / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005755:Gastrins / Q000378:metabolism; D005756:Gastritis / Q000473:pathology; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori / Q000502:physiology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index
chemical_list: D005755:Gastrins