Pathological Feature of Esophagogastric Adenocarcinoma Tadakazu Shimoda 1 , Ryoji Kushima 2 , Hatsu Takizawa 3 1Center for Cancer Control and Information Services, National Cancer Center Hospital, Tokyo 2Pathology of Clinical Laboratory Division, National Canter Center Hospital, Tokyo 3Endoscopy Division, National Cancer Center Hospital, Tokyo Keyword: 食道胃接合部腺癌 , 胃噴門腺 , 食道噴門腺 , Barrett食道 , GERD pp.1083-1094
Published Date 2009/6/25
DOI https://doi.org/10.11477/mf.1403101698
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 Pathological and anatomical evaluation of esophagogastric junction(EGJ)is very important for understanding of EGJ cancer. We described normal condition of histological features of EGJ. Histologically, gastric and esophageal cardic glands exist 20mm in length on the EGJ. In the lower esophagus, columnar epithelial island(CLE), which is exposed in the surface of squamous epithlelium, could be found frequently. This CLE shows proliferative activity. Esophageal cardiac glands and CLEs might play important rule in the development of Barrett's esophagus.

 The definition of EGJ cancer is proposed that epicenter of cancer is exist in gastric and cardiac gland mucosa. Among EGJ adenocarcinoma, gastric cardiac gland type is most common, and BE type is low incidence in Japanese yet. Another way of adenocarcinoma of lower esophagus is suggested from esophageal cardiac glands or basal layer of squamous epithelium. Common gastric cardiac cancer shows high incidence of esophageal spreading into the propria mucosa. There is two distinct pathway of carcinogenesis of EGJ-adenocarcinoma related or unrelated to intestinal metaplasia and consistent gastroesophageal reflux disease might play important role in the development of EGJ-adenocarcinoma.

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