Histopathological Characteristics of Early Cancer in the Esophagogastric Junction, Compared with Gastric Early Cancer in the Upper Portion Yasuo Ohkura 1 , Hiroyuki Morinaga 1 , Seiji Igarashi 2 , Kaoru Hirabayashi 2 1Department of Pathology, Kyorin University School of Medicine, Tokyo 2Department of Pathology, Tochigi Cancer Center, Utsunomiya, Japan Keyword: 食道胃接合部癌 , 早期癌 , 腺癌 , 病理学的特徴 , 胃上部癌 pp.1095-1103
Published Date 2009/6/25
DOI https://doi.org/10.11477/mf.1403101699
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 According to the revision of the guidelines for the clinical and pathological studies on carcinoma of the esophagus, the esophagogastric junctional carcinoma (EGJC)is defined as existing when there is a center of a carcinoma less than 2 cm above or below the esophagogastric junctional line (EGJL). Under this definition, the pathological characteristics of EGJC are studied in thirty-one cases of early cancers as compared with fifty-five cases of early gastric carcinoma located in the upper portion of the body (UGC).

 Compared with the UGC, the average age of the EJGC patients is higher and there is a slightly higher proportion of males among the total number of cases. EJGC is mostly located in the lesser curvature, but UGCs are located in the lesser curvature and in the posterior wall. The macroscopic type of EGJC is not only superficial depressed type but also protruded type. The greatest dimension of EGJC is perpendicular to the major axis. SM cancers are more numerous M cancers. The histologic type is mostly well differentiated tubular adenocarcinoma, and there are not signet-ring cell carcinomas or poorly differentiated adenocarcinoma. Concerning the mucin phenotype of carcinoma, the gastric predominant type is most numerous. So clinicopathologically EGJC is different from UGC clinicopathologically.

 When EGJC cases are studied according to the sub-location, such as E, GE, E=G, EG, G, which defined by the guidelines, in five locations, G is different from other areas in macroscopic type, invasion depth, histologic type and mucin phenotype. Considering these results, the definition of EGJC should be changed to include carcinomas whose center is less than 1cm above or below the EGJL, and in contact with or spreading across the EGJL.

 So carcinomas of EG,E=G and GE will be the true EGJCs. Examining the surrounding mucosa,EG and E=G are shift to the fundic gland mucosa, and GE shifts to the gastric mucosa with intestinal metaplasia. Thus,E=G may have the same break point as EG.

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