Definition of carcinoma of the gastric cardia

Abstract

This study concerns the definition of carcinoma of the gastric cardia. The topography of the esophagogastric mucosal junction (mucosal EGJ) was investigated with an endoscope in 182 patients who were free of hiatal hernias, ulcers, and neoplasms in the esophagus and stomach. The relationship between the EGJ and the cardiac gland area was then examined histologically in 56 resected specimens containing intact EGJs and cardia gland areas. Furthermore the cancerous center was determined; the shortest distance between the cancerous center and the EGJ and the amount of esophageal invasion were measured in 102 resected carcinomas located close to the junction; the carcinomas contained the EGJ and were good enough for pathohistological examination. The EGJ was located 0.5 - 1.0 cm proximal to the His angle (the gastric cardia) in radiological and endoscopic examinations. Histologically the cardiac gland area was found to straddle the EGJ at a range of about 1 cm proximal and 2 cm distal to the junction. Among the upper stomach carcinomas, most of the tumors (87.5%) whose center was located within 2 cm from the EGJ invaded the esophagus. In conclusion, carcinoma of the gastric cardia is defined as a lesion with its center located within 1 cm proximal and 2 cm distal to the EGJ.

Effect of Helicobacter pylori Infection Combined with CagA and Pepsinogen Status on Gastric Cancer Development among Japanese Men and Women: A Nested Case-Control Study

“…Previous studies have shown an increased risk of distal gastric cancer for H. pylori -seropositive subjects compared with seronegative subjects, whereas no association was observed among upper third gastric cancer (25)(26)(27) but not all (23,36,37). The discrepancy in results between studies may, to some extent, be due to different levels of misclassification of cardia cancers, such as the recent introduction of a separate diagnostic code, the lack of consensus for a definition of cardia, and an increased interest in cardia cancers (38,39). The definition of cardia cancer (upper third) was more inclusive than most definitions used outside Japan and would include NOTE: Pepsinogen index (À), pepsinogen I >70 or pepsinogen I/II ratio >3; (+), pepsinogen I V70 and pepsinogen I/II ratio V3, excluding pepsinogen index 2+ and 3+; (2+), pepsinogen I V50 and pepsinogen I/II ratio V3, excluding pepsinogen index 3+; (3+), pepsinogen I V30 and pepsinogen I/II ratio V2.…”

The dichotomy in carcinogenesis of the distal esophagus and esophagogastric junction: intestinal-type vs cardiac-type mucosa-associated adenocarcinoma

“…Tumors were initially classified by anatomic site, using the Siewert classification system, one of the most commonly used anatomic classification systems for tumors of the esophagogastric junction. 3,18,19 This system includes only tumors arising within 5 cm of the esophagogastric junction, and defines the anatomic esophagogastric junction as the site where the proximal gastric rugal folds terminate and the tubular esophagus begins. Type 1 tumors are those arising with their epicenter within 1-5 cm proximal to the esophagogastric junction, whereas type 3 arise within 2-5 cm distal to the esophagogastric junction, and are considered to represent tumors of the subcardia that have spread into the esophagogastric junction from below.…”

Interleukin‐1B (IL‐1B) polymorphisms and gastric mucosal levels of IL‐1β cytokine in Korean patients with gastric cancer

“…Cancer of the gastric cardia (n ϭ 20) was defined as an adenocarcinoma with its center located within 1 cm proximal and 2 cm distal to the gastroesophageal junction. 31 Adenocarcinoma of the antrum or body or fundus was defined as a noncardia cancer (n ϭ 214).…”