title: Comparison of gastro-oesophageal junction carcinomas in Chinese versus American patients.
abstract: OBJECTIVE
  To compare the clinical and pathological features of gastro-oesophageal junction (GEJ) carcinomas in Chinese and American patients.
  
  
  RESULTS
  Eighty consecutive patients with a GEJ carcinoma (43 from mainland China, and 37 from the USA) were evaluated for association with Barrett oesophagus (BO), chronic Helicobacter pylori gastritis, intestinal metaplasia, and outcome. GEJ carcinomas were defined as tumours that were located within 20 mm of, and crossed, the GEJ. Overall, GEJ carcinomas from Chinese patients revealed significantly more frequent location in the proximal stomach, higher pathological stage, larger size, younger patient age, and association with chronic H. pylori gastritis. In contrast, GEJ cancers from American patients showed a strong association with distal oesophageal location, BO, and associated intestinal metaplasia and dysplasia. Pathologically, GEJ carcinomas from American patients were predominantly adenocarcinomas, whereas Chinese patients showed a higher proportion of mucinous, adenosquamous, acinar or neuroendocrine tumours. Overall, 3- and 5-year survival rates were statistically similar between both patient groups, but upon multivariate analysis, Chinese patients showed statistically better survival rates for stage III tumours.
  
  
  CONCLUSIONS
  Most GEJ carcinomas in patients from China represent proximal gastric cancers associated with chronic H. pylori gastritis, and BO-associated carcinomas are rare among this patient population.
authors: Department of Pathology of the Nanjing Drum Tower Hospital, Nanjing, China.
authors: Qin
authors: Q
authors: Huang
authors: Xiangshan
authors: X
authors: Fan
authors: Agoston T
authors: AT
authors: Agoston
authors: Anning
authors: A
authors: Feng
authors: Huiping
authors: H
authors: Yu
authors: Gregory
authors: G
authors: Lauwers
authors: Lihua
authors: L
authors: Zhang
authors: Robert D
authors: RD
authors: Odze
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology; D002681:China / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000150:complications / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology