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Cardiac Mucosa

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Gastric Cardiac Cancer

Abstract

Despite some controversial on the nature of cardiac mucosa, the overwhelming high-quality evidence from studies in fetus, newborns, children, and adults in various ethnic populations has firmly established the congenital nature of this mucosa with a few new features: (1) the length of cardiac mucosa is much shorter than previously believed; (2) the distrisbution pattern of cardiac mucosa varies among different populations with a more predominant presence in the gastric cardia in the East Asian population, compared to the Western Caucasian population; (3) cardiac mucosa is plastic and dynamic in response to changes in local microenvironment that modify its length and distribution patterns.

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References

  1. Krause WJ, Ivey KJ, Baskin WN, MacKercher PA. Morphological observations on the normal human cardiac glands. Anat Rec. 1978;192(1):59–71.

    Article  CAS  PubMed  Google Scholar 

  2. Fawcett D. Chapter 25: The esophagus and stomach. In: Bloom W, Fawcett DW, editors. A textbook of histology. 12th ed. New York: Chapman and Hall; 1994. p. 593–616.

    Google Scholar 

  3. Takubo K, Arai T, Sawabe M, et al. Structures of the normal esophagus and Barrett’s esophagus. Esophagus. 2003;1:37–47.

    Article  Google Scholar 

  4. Owen DA. Stomach. In: Sternberg SS, editor. Histology for pathologists. 2nd ed. New York: Raven Press; 1997. p. 481–93.

    Google Scholar 

  5. Fan XS, Feng AN, Zhang LH, Lauwers G, Huang Q. Esophageal columnar metaplasia is common in the distal esophagus of Chinese patients. Gastroenterology. 2010;138(5 Suppl 1):S758.

    Google Scholar 

  6. Huang Q, Zhang LH. Histopathologic features of esophageal glands in the region of the gastroesophageal junction in Chinese patients with gastric cardiac cancer involving the esophagus. Pathol Lab Med Int. 2010;2:33–40.

    Article  Google Scholar 

  7. Yagi K, Nakamura A, Sekine A, Umezu H. The prevalence of esophageal cardiac glands: relationship with erosive esophagitis and nonerosive reflux disease (NERD) in Japanese patients. Endoscopy. 2006;38(6):652–3.

    Article  CAS  PubMed  Google Scholar 

  8. Sun Q, Huang Q, Feng AN, et al. Columnar-lined esophagus in Chinese patients with proximal gastric carcinomas. J Dig Dis. 2013;14(1):22–8.

    Article  PubMed  Google Scholar 

  9. Chandrasoma PT, Der R, Ma Y, Dalton P, Taira M. Histology of the gastroesophageal junction: an autopsy study. Am J Surg Pathol. 2000;24(3):402–9.

    Article  CAS  PubMed  Google Scholar 

  10. Chandrasoma PT, Lokuhetty DM, Demeester PT, et al. Definition of histopathologic changes in gastroesophageal reflux disease. Am J Surg Pathol. 2000;24:344–51.

    Article  CAS  PubMed  Google Scholar 

  11. Chandrasoma PT, Der R, Ma Y, Peters J, Demeester T. Histologic classification of patients based on mapping biopsies of the gastroesophageal junction. Am J Surg Pathol. 2003;27(7):929–36.

    Article  PubMed  Google Scholar 

  12. Kilgore SP, Ormsby AH, Gramlich TL, et al. The gastric cardia: fact or fiction. Am J Gastroenterol. 2000;95:921–4.

    Article  CAS  PubMed  Google Scholar 

  13. Sarbia M, Donner A, Gabbert HE. Histopathology of the gastroesophageal junction: a study on 36 operation specimens. Am J Surg Pathol. 2002;26(9):1207–12.

    Article  PubMed  Google Scholar 

  14. Chandrasoma P, Makarewicz K, Wickramasinghe K, Ma Y, Demeester T. A proposal for a new validated histological definition of the gastroesophageal junction. Hum Pathol. 2006;37(1):40–7.

    Article  PubMed  Google Scholar 

  15. Wijnhoven BP, Siersema PD, Hop WC, et al. Adenocarcinomas of the distal oesophagus and gastric cardia are one clinical entity. Rotterdam Oesophageal Tumour Study Group. Br J Surg. 1999;86:529–35.

    Article  CAS  PubMed  Google Scholar 

  16. Dolan K, Morris AI, Gosney JR, Field JK, Sutton R. Three different subsite classification systems for carcinomas in the proximity of the GEJ, but is it all one disease? J Gastroenterol Hepatol. 2004;19(1):24–30.

    Article  PubMed  Google Scholar 

  17. Chandrasoma P, Wickramasinghe K, Ma Y, et al. Adenocarcinomas of the distal esophagus and “gastric cardia” are predominantly esophageal carcinomas. Am J Surg Pathol. 2007;31:569–75.

    Article  PubMed  Google Scholar 

  18. American Joint Committee on Cancer. Chapter 10: Esophagus and esophagogastric junction. In:AJCC cancer staging manual. 7th ed. New York: Springer; 2009. p. 103–15.

    Google Scholar 

  19. Huang Q. Controversies of cardiac glands in the proximal stomach: a critical review. J Gastroenterol Hepatol. 2011;26:450–5.

    Article  PubMed  Google Scholar 

  20. Salenius P. On the ontogenesis of the human gastric epithelial cells. A histologic and histochemical study. Acta Anat (Basal). 1962;50(Suppl 46):S1–S76.

    Google Scholar 

  21. De Hertogh G, Van Eyken P, Ectors N, Tack J, Geboes K. On the existence and location of cardiac mucosa: an autopsy study in embryos, fetuses, and infants. Gut. 2003;52(6):791–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zhou H, Greco MA, Daum F, Kahn E. Origin of cardiac mucosa: ontogenic consideration. Pediatr Dev Pathol. 2001;4(4):358–63.

    Article  CAS  PubMed  Google Scholar 

  23. Park YS, Park HJ, Kang GH, Kim CJ, Chi JG. Histology of gastroesophageal junction in fetal and pediatric autopsy. Arch Pathol Lab Med. 2003;127(4):451–5.

    PubMed  Google Scholar 

  24. Marsman WA, van Sandick JW, Tytgat GN, ten Kate FJ, van Lanschot JJ. The presence and mucin histochemistry of cardiac type mucosa at the esophagogastric junction. Am J Gastroenterol. 2004;99(2):212–7.

    Article  CAS  PubMed  Google Scholar 

  25. Derdoy JJ, Bergwerk A, Cohen H, Kline M, Monforte HL, Thomas DW. The gastric cardia: to be or not to be? Am J Surg Pathol. 2003;27(4):499–504.

    Article  PubMed  Google Scholar 

  26. Glickman JN, Fox V, Antonioli DA, Wang HH, Odze RD. Morphology of the cardia and significance of carditis in pediatric patients. Am J Surg Pathol. 2002;26(8):1032–9.

    Article  PubMed  Google Scholar 

  27. Huang Q. Definition of the esophagogastric junction. Arch Pathol Lab Med. 2011;135(3):384–9.

    PubMed  Google Scholar 

  28. Peitz U, Vieth M, Malfertheiner P. Carditis at the interface between GERD and Helicobacter pylori infection. Dig Dis. 2004;22(2):120–5.

    Article  CAS  PubMed  Google Scholar 

  29. Oberg S, Peters JH, DeMeester TR, et al. Inflammation and specialized intestinal metaplasia of cardiac mucosa is a manifestation of gastroesophageal reflux disease. Ann Surg. 1997;226(4):522–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Nakanishi Y, Saka M, Eguchi T, Sekine S, Taniguchi H, Shimoda T. Distribution and significance of the oesophageal and gastric cardiac mucosae: a study of 131 operation specimens. Histopathology. 2007;51(4):515–9.

    Article  CAS  PubMed  Google Scholar 

  31. Chandrasoma P. Controversies of the cardiac mucosa and Barrett’s esophagus. Histopathology. 2005;46:361–73.

    Article  CAS  PubMed  Google Scholar 

  32. Takubo K, Vieth M, Aryal G, Honma N, et al. Islands of squamous epithelium and their surrounding mucosa in columnar-lined esophagus: a pathognomonic feature of Barrett’s esophagus? Hum Pathol. 2005;36(3):269–74.

    Article  PubMed  Google Scholar 

  33. El-Serag HB, Graham DY, Rabeneck L, Avid A, Richardson P, Genta RM. Prevalence and determinants of histological abnormalities of the gastric cardia in volunteers. Scand J Gastroenterol. 2007;42(10):1158–66.

    Article  PubMed  Google Scholar 

  34. Misumi A, Murakami A, Harada K, Baba K, Akagi M. Definition of carcinoma of the gastric cardia. Langenbecks Arch Chir. 1989;374(4):221–6.

    Article  CAS  PubMed  Google Scholar 

  35. Japanese Research Society for Gastric Cancer. The general rules for gastric cancer. Jpn J Surg. 1973;3:61–71.

    Article  Google Scholar 

  36. Law S, Lam KY, Chu KM, Wong J. Specialized intestinal metaplasia and carditis at the gastroesophageal junction in Chinese patients undergoing endoscopy. Am J Gastroenterol. 2002;97(8):1924–9.

    Article  PubMed  Google Scholar 

  37. Huang Q, Fan XS, Agoston AT, et al. Comparison of gastroesophageal junction carcinomas in Chinese versus American patients. Histopathology. 2011;59(2):188–97.

    Article  PubMed  Google Scholar 

  38. Mörk H, Barth T, Kreipe HH, et al. Reconstitution of squamous epithelium in Barrett’s oesophagus with endoscopic argon plasma coagulation: a prospective study. Scand J Gastroenterol. 1998;33(11):1130–4.

    Article  PubMed  Google Scholar 

  39. Huang Q, Fang DC, Yu CG, Zhang J, Chen MH. Barrett’s esophagus-related diseases remain uncommon in China. J Dig Dis. 2011;12(6):420–7.

    Article  PubMed  Google Scholar 

  40. Huang Q, Shi J, Sun Q, et al. Distal esophageal carcinomas in Chinese patients vary widely in histopathology, but adenocarcinomas remain rare. Hum Pathol. 2012;43(12):2138–48.

    Article  PubMed  Google Scholar 

  41. Hongo M, Nagasaki Y, Shoji T. Epidemiology of esophageal cancer: Orient to Occident. Effects of chronology, geography and ethnicity. J Gastroenterol Hepatol. 2009;24(5):729–35.

    Article  PubMed  Google Scholar 

  42. Spechler SJ. Cardiac mucosa, Barrett’s oesophagus and cancer of the gastro-oesophageal junction: what’s in a name? Gut. 2017;66(8):1355–7. https://doi.org/10.1136/gutjnl-2016-311948. pii: gutjnl-2016-311948.

    Article  PubMed  Google Scholar 

  43. Reis-Filho JS, Schmitt FC. Taking advantage of basic research: p63 is a reliable myoepithelial and stem cell marker. Adv Anat Pathol. 2002;9(5):280–9.

    Article  PubMed  Google Scholar 

  44. Huang Q, Zou XP. Clinicopathology of early gastric carcinoma: an update for pathologists and gastroenterologists. Gastrointest Tumors. 2017;3(3–4):115–24.

    PubMed  PubMed Central  Google Scholar 

  45. Wang X, Ouyang H, Yamamoto Y, et al. Residual embryonic cells as precursors of a Barrett’s-like metaplasia. Cell. 2011;145:1023–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Huang Q, Zhang LH. The histopathologic spectrum of carcinomas involving the gastroesophageal junction in the Chinese. Int J Surg Pathol. 2007;15(1):38–52.

    Article  PubMed  Google Scholar 

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Huang, Q. (2018). Cardiac Mucosa. In: Huang, Q. (eds) Gastric Cardiac Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-79114-2_2

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  • DOI: https://doi.org/10.1007/978-3-319-79114-2_2

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  • Publisher Name: Springer, Cham

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