title: Cardiac mucosa at the gastro-oesophageal junction: indicator of gastro-oesophageal reflux disease? Data from a prospective central European multicentre study on histological and endoscopic diagnosis of oesophagitis (histoGERD trial).
abstract: OBJECTIVE
  The origin and significance of cardiac mucosa at the gastro-oesophageal junction are controversial. In the prospective Central European multicentre histoGERD trial, we aimed to assess the prevalence of cardiac mucosa, characterized by the presence of glands composed of mucous cells without parietal cells, and to relate its presence to features related to gastro-oesophageal reflux disease (GORD).
  
  
  RESULTS
  One thousand and seventy-one individuals (576 females and 495 males; median age 53 years) were available for analysis. Overall, in biopsy specimens systematically taken from above and below the gastro-oesophageal junction, cardiac mucosa was observed in 713 (66.6%) individuals. Its presence was associated with patients' symptoms and/or complaints (P = 0.0025), histological changes of the squamous epithelium (P < 0.001) indicative of GORD, intestinal metaplasia (P < 0.001), and an endoscopic diagnosis of oesophagitis (P < 0.001). No association with an endoscopic diagnosis of Barrett's oesophagus or with gastric pathology, particularly Helicobacter infection, was observed.
  
  
  CONCLUSIONS
  Cardiac mucosa is a common finding in biopsy specimens taken from the gastro-oesophageal junction. Its association with reflux symptoms, histological changes indicating GORD and the endoscopic diagnosis of oesophagitis suggests that injury and repair related to GORD contribute to its development and/or expansion.
authors.affiliation: Institute of Pathology, Medical University of Graz, Graz, Austria.
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
authors.forename: Nora I
authors.initials: NI
authors.lastname: Schneider
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Plieschnegger
authors.forename: Bertram
authors.initials: B
authors.lastname: Schmack
authors.forename: Hartmut
authors.initials: H
authors.lastname: Bordel
authors.forename: Bernd
authors.initials: B
authors.lastname: Höfler
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Eherer
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Wolf
authors.forename: Peter
authors.initials: P
authors.lastname: Rehak
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia / Q000473:pathology*; D002648:Child; D004942:Esophagitis, Peptic / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005764:Gastroesophageal Reflux / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
keywords: gastric cardia; gastro-oesophageal junction; metaplasia; prevalence; reflux disease