title: Recent advances in proximal gastric carcinoma.
abstract: The American Joint Committee on Cancer (AJCC) staging scheme requires staging proximal gastric carcinoma (PGC) as esophageal adenocarcinoma (EAC), which has been shown to be controversial by recent research results. To update the current research findings on PGC, we systematically reviewed and analyzed the scientific evidence on key arguments related to PGC. The data of high-quality research articles showed that PGC arised in the cardiac mucosa in the proximal stomach within 3 cm below the gastroesophageal junction. Its incidence is rising in East Asian countries, but decreasing in the West, and plateaued at a low level in the United States. PGC is a slowly progressive cancer with unknown independent risk factors and the mechanisms of pathogenesis. This carcinoma exhibits a wide histopathological spectrum and heterogeneous post-resection patient survival characteristics, and cannot be adequately staged for prognotic stratification by the current AJCC staging classification. The results on PGC genomics reveal unique genetic profiles, especially in East Asian populations. In conclusion, mounting evidence defies a simple placement of PGC in a single category of EAC for disease classification; further investigations on the mechanisms of PGC pathogenesis are urgently needed.
authors.affiliation: Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China. qinhuang0122@gmail.com.|Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, MA, USA. qinhuang0122@gmail.com.
authors.forename: Qin
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Xiang Shan
authors.initials: XS
authors.lastname: Fan
authors.affiliation: Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, MA, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Zou
mesh_terms: D000367:Age Factors; D018450:Disease Progression; D020022:Genetic Predisposition to Disease; D015386:Hazardous Substances / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D009367:Neoplasm Staging; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000601:surgery
chemical_list: D015386:Hazardous Substances
keywords: Helicobacter pylori; carcinoma; gastric carcinoma; gastric cardia; proximal stomach; stomach