Publication: Histopathological features of the gastroesophageal junction: an Eastern view
Authors
Kim, Ahrong ; Shin, Nari ; Lee, Hyung-Jeong ; Jo, Hong-Jae ; Kim, Joo-Yeon ; Kim, Young-Keum ; Park, Do Youn ; I, Hoseok ; Kim, Gwang Ha
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Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
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DOI
10.14670/HH-30.689
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info:eu-repo/semantics/article
Description
Abstract
The definition and features of the
gastroesophageal junction (GEJ) and the histopathologic features of the cardiac mucosa remain
controversial. Most reports originate from western
countries, which have different prevalence of GEJ
adenocarcinoma and gastroesophageal reflux disease
(GERD) compared to eastern countries. Therefore, we
investigated GEJ anatomic and histopathologic features
by histological mapping in 30 esophagogastrectomy
specimens of middle and lower esophageal squamous
cell carcinoma. We measured the lengths of the cardiac
mucosa, oxyntocardiac mucosa, and esophageal cardiactype glands. We assessed the presence of intestinal
metaplasia, pancreatic acinar cells, Brunner’s-like
glands, and submucosal esophageal gland beneath
cardiac mucosa and the relationship of these features
with age and the circumferential location of cardiac
mucosa. The lengths of cardiac mucosa and esophageal
cardiac-type glands significantly increased with age (<63
years, 2767.86±734.95 µm vs. ≥63 years,
5453.12±839.52 µm, P=0.025 and <63 years,
1151.78±452.81 µm vs. ≥63 years, 2273.44±321.58 µm,
P=0.049, respectively) and the presence of
circumferential cardiac mucosa (+, 5731.25±721.57 vs.
−, 2625.00±356.00 µm, P=0.007; +, 2425.00±326.13 µm
vs. −, 400.00±204.80 µm, P<0.0001 respectively). The
presence of intestinal metaplasia and irregular GEJ
increased with age and the circumferential location ofcardiac mucosa. The presence of esophageal submucosal
glands beneath the cardiac mucosa, pancreatic acinar
cells, and Brunner-like glands were seen in 8/30
(26.7%), 15/30 (50%), and 14/30 (46.7%) cases,
respectively. These data indirectly suggest that cardiac
mucosa originated from the distal esophagus and that the
presence of cardiac mucosa may indicate GERD, in
accordance with data from Western countries.
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Citation
Histology and Histopathology, vol. 30, nº 6, (2015)
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