Skip to main content

Pathologic Features of Esophageal and Gastric Malignancies

  • Chapter
  • First Online:

Part of the book series: Cancer Treatment and Research ((CTAR))

Abstract

Esophageal and gastric carcinomas affect millions of individuals worldwide, placing a considerable burden on society. Unfortunately, preventative medicine falls short as screening methods for the upper gastrointestinal tract lack the ability to detect early onset disease. The overwhelming majority of cases present after symptoms appear when individuals have advanced disease with a poor prognosis.  Further complicating matters, the anatomic location of these neoplasms engenders rapid tumor progression, which repeatedly thwarts successful surgical treatment.  This chapter will focus on the pathological features of malignant neoplasms of the esophagus and stomach.

Eduard Matkovic, MD and Michael Schwalbe, MD have contributed equally.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ando N et al (2000) Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 232(2):225–232

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Arber N et al (1996) Increased expression of the cyclin D1 gene in Barrett’s esophagus. Cancer Epidemiol Biomarkers Prev 5:457–459

    CAS  PubMed  Google Scholar 

  3. Berger AC et al (2005) Complete response to neoadjuvant chemoradiotherapy in esophageal carcinoma is associated with significantly improved survivial. J Clin Oncol 23:4330–4337

    Article  PubMed  Google Scholar 

  4. Bertuccio P, Chatenoud L, Fabio L et al (2009) Recent patterns in gastric cancer: a global overview. Int J Cancer 125:666–673

    Article  CAS  PubMed  Google Scholar 

  5. Bria E, Manzoni G, Beghelli S et al (2013) A clinical-biological risk stratification model for resected gastric cancer: prognostic impact of Her2, Fhit, and APC expression status. Ann Oncol 24:693–701

    Article  CAS  PubMed  Google Scholar 

  6. Brown LM et al (2002) Epidemiologic trends in esophageal and gastric cancer in the United States. Surg Oncol Clin N Am 11:235

    Article  PubMed  Google Scholar 

  7. Brown LM et al (2008) Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst 100:1184–1187

    Article  PubMed  PubMed Central  Google Scholar 

  8. Buskens CJ et al (2002) Prognostic significance of elevated cyclooxygenase 2 expression in patients with adenocarcinoma of the esophagus. Gastroenterol 122:1800–1807

    Article  CAS  Google Scholar 

  9. Cisco R, Ford J, Norton J (2008) Hereditary diffuse gastric cancer: implications of genetic testing for screening and prophylactic surgery. Cancer 113(7):1850–1856

    Article  CAS  PubMed  Google Scholar 

  10. Correa P, Shiao Y (1994) Phenotypic and genotypic events in gastric carcinogenesis. Cancer Res 54:1941s–1943s

    CAS  PubMed  Google Scholar 

  11. De Vries A, Van Grieken N, Looman C (2008) Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology 134:945–952

    Article  PubMed  Google Scholar 

  12. Derdoy J, Bergwerk A, Cohen H et al (2003) The gastric cardia: to be or not to be? Am J Surg Pathol 27(4): 499–504

    Google Scholar 

  13. Devesa SS et al (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83:2049

    Article  CAS  PubMed  Google Scholar 

  14. Edge SB et al (2010). American joint committee on cancer staging manual, 7th edn. Springer, New York

    Google Scholar 

  15. Falk GW et al (1999) Jumbo biopsy forceps protocol still misses unsuspected cancer in Barrett’s esophagus with high-grade dysplasia. Gastrointest Endosc 49(2):170–176

    Article  CAS  PubMed  Google Scholar 

  16. Ferro A, Peletiero B, Malvezzi M et al (2014) Worldwide trends in gastric cancer mortality (1980–2011), with predictions to 2015, and incidence by subtype. Eur J Cancer 50:1330–1344

    Article  PubMed  Google Scholar 

  17. Forman D, Burley VJ (2006) Gastric cancer: global pattern of the disease and overview of environmental risk factors. Best Pract Res Cl Ga 20(4):633–649

    Article  CAS  Google Scholar 

  18. Gleeson CM et al (1998) Comparison of p53 and DNA content abnormalities in adenocarcinoma of the oesophagus and gastric cardia. Br J Cancer 77:277–286

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Goldblum JR et al (2010) Sternberg’s diagnostic surgical pathology. In: Mills SE (ed) 5th edn, vol 2,31. Lippincott Williams and Wilkins, pp 1249–1278

    Google Scholar 

  20. Guillaume P, Messager M, Leteurtre E et al (2009) Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887

    Article  Google Scholar 

  21. Hartgrink H, Jansen E, van Grieken N, van de Held C (2009) Gastric cancer. Lancet 374:477–490

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hu B, Hajj N, Sittler S et al (2012) Gastric cancer: classification, histology and application of molecular pathology. J Gastrointest Oncol 3(3):251–261

    PubMed  PubMed Central  Google Scholar 

  23. Iwata T et al (2007) p53 and MIB-1 espression of esophageal carcinoma concomitant with achalasia. Hepatogastroentero 54:1430–1432

    Google Scholar 

  24. Izzo JG et al (2006) Association of activated transcription factor nuclear factor kappab with chemoradiation resistance and poor outcome in esophageal carcinoma. J Clin Oncol 24:748–754

    Article  CAS  PubMed  Google Scholar 

  25. Jenkins GJ et al (2002) Genetic pathways involved in the progression of Barrett’s metaplasia to adenocarcinoma. Br J Surg 89:824–837

    Article  CAS  PubMed  Google Scholar 

  26. Jiang W et al (1993). Altered expression of the cyclin D1 and retinoblastoma genes in human esophageal cancer. Proc Natl Acad Sci USA 1, 90(19):9026–9030

    Google Scholar 

  27. Kalish RJ et al (1984) Clinical, epidemiologic, and morphologic comparison between adenocarcinomas arising in Barrett’s esophageal mucosa and in the gastric cardia. Gastroenterology 86(3):461–467

    CAS  PubMed  Google Scholar 

  28. Kelley JR, Duggan JM (2003) Gastric cancer epidemiology and risk factors. J Cli Epi 56(1):1–9

    Article  Google Scholar 

  29. Kim R et al (1997) Etiology of Barrett’s metaplasia and esophageal adenocarcinoma. Cancer Epidem Biomarker Prev. 6:369–377

    CAS  Google Scholar 

  30. Kirkwood K, Khitin L, Barwick K (1997) Prognostic indicators for cancer. Surg Oncol Clin North Am 6:495–514

    CAS  Google Scholar 

  31. Kunz P, Gubens M, Fisher G et al (2012) Long-term survivors of gastric cancer: a California population-based study. J Clin Oncol 30(28):3507–3515

    Article  PubMed  Google Scholar 

  32. Lagarde SM et al (2007) Molecular prognostic factors in adenocarcinoma of the esophagus and gastreophageal junction. Ann Surg Oncol 14:977–991

    Article  CAS  PubMed  Google Scholar 

  33. Lagergren J (2005). Adenocarcinoma of the oesophagus: what exactly is the size of the problem and who is at risk? Gut 54 Suppl 1:i1–i5

    Google Scholar 

  34. Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type Carcinoma. An attempt at histo-clinical classification. Acta Pathol Microbiol Scand 64:31–49

    CAS  PubMed  Google Scholar 

  35. Lauwers GY, Carniero F, Graham DY et al (2010) Gastric carcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND (eds) WHO classification of tumour of the digestive system. IACR, Lyon

    Google Scholar 

  36. Ludmir EB et al (2015) Human papillomavirus tumor infection in esophageal squamous cell carcinoma. J Gastrointest Oncol 6(3):287–295

    PubMed  PubMed Central  Google Scholar 

  37. Mills SE et al (2010). Sternberg’s diagnostic surgical pathology, 5th edn, vol 2, 31. Lippincott Williams and Wilkins, pp 1249–1278

    Google Scholar 

  38. Montesano R et al (1996) Genetic alterations in esophageal cancer and their relevance to etiology and pathogenesis: a review. Int J Cancer 69(3):225–235

    Article  CAS  PubMed  Google Scholar 

  39. Montgomery et al (2010). Squamous cell carcinoma of the oesophagus. In: Bosman FT, Carneiro F, Hruban RH (eds) WHO classification of tumors of the digestive system. Theise ND. World Health Organization, International Agency for Research on Cancer, Lyon, France, pp 18–24

    Google Scholar 

  40. Morales CP et al (2002) Hallmarks of cancer progression in Barrett’s oesophagus. Lancet 360:1587–1589

    Article  PubMed  Google Scholar 

  41. Morisaki Y et al (1996) Adenoid cystic carcinoma of the esophagus: report of a case and review of the Japanese literature. Surg Today 26:1006–1009

    Article  CAS  PubMed  Google Scholar 

  42. Naumann M, Crabtree J (2004) Helicobacter pylori-induced epithelial cell signalling in gastric carcinogenesis. Trends Microbiol 12(1):29–36

    Article  CAS  PubMed  Google Scholar 

  43. Ohshima H, Bartsch H (1994) Chronic infections and inflammatory processes as cancer risk factors: possible role of nitric oxide in carcinogenesis. Mutat Res 305:253–264

    Article  CAS  PubMed  Google Scholar 

  44. Paris workshop (2002) The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon. Gastrointest Endosc 58(6): S3–S43

    Google Scholar 

  45. Pennathur A et al (2013) Lancet 381(9864):400–412

    Article  PubMed  Google Scholar 

  46. Pohl H et al (2010). Esophageal adenocarcinoma incidence: are we reaching the peak? Cancer Epidemiol Biomarkers Prev 19:1468

    Google Scholar 

  47. Qiu SL et al (1988) Precursor lesions of esophageal cancer in high-risk populations in Henan Province. China Cancer 62(3):551–557

    Article  CAS  PubMed  Google Scholar 

  48. Raza MA et al (2011) Sarcomatoid carcinoma of esophagus. Arch Pathol Lab Med 135(7):945–948

    PubMed  Google Scholar 

  49. Rice TW et al (2001) Superficial adenocarcinoma of the esophagus. J Thorac Cardiovasc Surg 122:1077–1090

    Article  CAS  PubMed  Google Scholar 

  50. Ruschoff J, Hanna W, Bilous M et al (2012) HER2 testing in gastric cancer: a practical approach. Mod Pathol 25:637–650

    Article  PubMed  Google Scholar 

  51. Saito T et al (2015) Molecular pathology and potential therapeutic targets in esophageal basaloid squamous cell carcinoma. Int J Clin Exp Pathol. 8(3):2267–2273

    CAS  PubMed  PubMed Central  Google Scholar 

  52. Sarbia M et al (1995) Incidence and prognostic significance of vascular and neural invasion in squamous cell carcinomas of the esophagus. Int J Cancer 4, 61(3):333–6

    Google Scholar 

  53. Serrano J et al (2000) Alterations in the p16INK4a/CDKN2A tumor suppressor gene in gastrinomas. J Clin Endocr Metab 85:4146–4156

    Article  CAS  PubMed  Google Scholar 

  54. Shimada H et al (2003) Treatment response and prognosis of patients after recurrence of esophageal cancer. Surgery 133(1):24–31

    Article  PubMed  Google Scholar 

  55. Siewert JR et al (2007) Adenocarcinoma of the esophagogastric junction: competition between Barrett and gastric cancer. J Am Coll Surg 205(4 Suppl):S49–S53

    Article  PubMed  Google Scholar 

  56. Sobin LH et al (2011) TNM classification of malignant tumours, 7th edn. Wiley-Blackwell, Oxford, UK

    Google Scholar 

  57. Taniere P et al (2002) Cytokeratin expression in adenocarcinomas of the esophagogastric junction: a comparative study of adenocarcinomas of the distal esophagus and of the proximal stomach. Am J Surg Pathol 26:1213–1221

    Article  PubMed  Google Scholar 

  58. Torres CM et al (1999) Pathologic prognostic factors in esophageal squamous cell carcinoma: a follow-up study of 74 patients with or without preoperative chemoradiation therapy. Mod Pathol 12(10):961–968

    CAS  PubMed  Google Scholar 

  59. Wang GQ et al (2005) Histological precursors of oesophageal squamous cell carcinoma: results from a 13 year prospective follow up study in a high risk population. Gut 54(2):187–192

    Article  PubMed  PubMed Central  Google Scholar 

  60. Washington K (2010) 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol 17:3077–3079

    Article  PubMed  Google Scholar 

  61. Webber C, Gospodarowicz M, Sobin LH, Wittekind C, Greene FL, Mason MD, Compton C, Brierley J, Groome PA (2014) Improving the TNM classification: findings from a 10-year continuous literature review. Int J Cancer 135(2):371–378

    Article  CAS  PubMed  Google Scholar 

  62. Wild CP et al (2003) Reflux, Barrett’s oesophagus and adenocarcinoma: burning questions. Nat Rev Cancer 3:676–684

    Article  CAS  PubMed  Google Scholar 

  63. Wu TT et al (2007) Excellent interobserver agreement on grading the extent of residual carcinoma after preoperative chemoradiation in esophageal and esophagogastric junction carcinoma: a reliable predictor for patient outcome. Am J Surg Pathol 31(1):58–64

    Article  PubMed  Google Scholar 

  64. Xing EP et al (1993). Aberrant methylation of p16INK4a and deletion of p15INK4b are frequent events in human esophageal cancer in Linxian, China. Proc Natl Acad Sci USA 1, 90(19):9026–9030 (Carcinogenesis. 20(1):77–84, 1999 Jan)

    Google Scholar 

  65. Yasui W, Sentani K, Motoshita J, Nakayama H (2006) molecular pathology of gastric cancer. Scand J Surg 95:225–231

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kristina A. Matkowskyj .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Matkovic, E., Schwalbe, M., Matkowskyj, K.A. (2016). Pathologic Features of Esophageal and Gastric Malignancies. In: Bentrem, D., Benson, A. (eds) Gastrointestinal Malignancies. Cancer Treatment and Research. Springer, Cham. https://doi.org/10.1007/978-3-319-34244-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-34244-3_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34242-9

  • Online ISBN: 978-3-319-34244-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics