Gastroesophageal Junction (GEJ) – Definition and Histopathologic Features – Eastern View
Ahrong Kim, Joo-yeon Kim, Nari Shin, Won-Young Park, Do Youn Park. Pusan National University Hospital, Busan, Korea
Background: There were debates about definition and features of GEJ and histopathologic features of gastric cardiac mucosa. However, most reports were originated from Western countries, which showed different prevalence of GEJ adenocarcinoma and GERD (gastroesophageal reflux disease) compared to Eastern countries.
Design: On this background, we have tried to investigate anatomic and histopathologic features of GEJ by histological mapping in 30 esophagogasterectomy specimens (mean age = 63) of middle and lower esophageal squamous cell carcinoma. We assessed following histologic features, including lengths of cardia mucosa (CM), oxyntocardiac mucosa (OCM), esophageal cardiac mucosa (ECM), and presence of intestinal metaplasia, pancreatic metaplasia, Brunner's like glands, submucosal esophageal gland beneath cardiac mucosa and their relationship with age, gross features of GEJ.
Results: Length of CM, ECM was significantly increased with age (<63, 2767.86 ±734.95 um vs ≥63, 5453.12±839.52um, p=0.025; <63, 1151.78±452.81um vs ≥63, 2273.44±321.58um, p=0.049). Presence of intestinal metaplasia (p=0.003), irregular GEJ (p=0.030) and circumferential location of cardiac mucosa (p=0.019) were also associated with increased with age. Presence of esophageal submucosal glands beneath cardiac mucosa, pancreatic metaplasia and Brunner-like glands were seen 8/30 (26.7%), 15/30 (50%), and 14/30 (46.7%) cases. Presence of ECM, columnar-lined esophagus was associated with irregular GEJ.
Conclusions: We concluded that gastric cardiac mucosa and irregularity of GEJ was associated with increase of age. Also these data indirectly suggest that gastric cardiac mucosa were originated from distal esophagus and presence of gastric cardia mucosa itself means evidence of GERD in similar with Western datasets of GEJ.
Monday, March 4, 2013 1:00 PM
Poster Session II # 106, Monday Afternoon