Endoscopic gastric mucosal atrophy distinguishes the characteristics of superficial esophagogastric junction adenocarcinoma

Uedo N 1 , Yoshio T 2 , Yoshinaga S 3 , Takeuchi M 4 , Hatta W 5 , Yano T 6 Show all authors , Tanuma T 7 , Goto O 8 , Takahashi A 9 , Tong D 10 , Lee YY 11 , Nakayama Y 12 , Ichihara S 13 , Gotoda T 14

Affiliations 

  • 1 Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • 2 Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
  • 3 Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • 4 Department of Gastroenterology, Nagaoka Red Cross Hospital, Niigata, Japan
  • 5 Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
  • 6 Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
  • 7 Center for Endoscopy, Teine Keijinkai Hospital, Sapporo, Japan
  • 8 Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
  • 9 Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan
  • 10 Division of Esophageal and Upper Gastrointestinal Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong
  • 11 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
  • 12 Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
  • 13 Department of Surgical Pathology, Sapporo Kosei General Hospital, Sapporo, Japan
  • 14 Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
Dig Endosc, 2017 Apr;29 Suppl 2:26-36.
PMID: 28425653 DOI: 10.1111/den.12849

Abstract

BACKGROUND AND AIM: Western studies have suggested two distinct etiologies of esophagogastric junction (EGJ) cancer: Helicobacter pylori-associated atrophic gastritis and non-atrophic gastric mucosa resembling esophageal adenocarcinoma. The present study investigated whether endoscopic gastric mucosal atrophy can distinguish between these two types of EGJ adenocarcinoma.

METHODS: Data were collected from patients with Siewert type II, T1 EGJ adenocarcinoma who underwent endoscopic or surgical resection at eight Japanese institutions in 2010-2015. Clinicopathological characteristics of EGJ cancers with and without endoscopic gastric mucosal atrophy were compared. EGJ was defined as the lower end of the palisade vein and/or the top of the gastric folds.

RESULTS: Of the 229 patients identified, 161 had endoscopic gastric mucosal atrophy and 68 did not. The latter group was younger (64 vs 70 years, P = 0.000); had a higher proportion of patients negative for H. pylori (90% vs 47%, P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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