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Histopathological features of the gastroesophageal junction: an Eastern view.
[esophageal squamous cell carcinoma]
The
definition
and
features
of
the
gastroesophageal
junction
(
GEJ
)
and
the
histopathologic
features
of
the
cardiac
mucosa
remain
controversial
.
Most
reports
originate
from
western
countries
,
which
have
different
prevalence
of
GEJ
adenocarcinoma
and
gastroesophageal
reflux
disease
(
GERD
)
compared
to
eastern
countries
.
Therefore
,
we
investigated
GEJ
anatomic
and
histopathologic
features
by
histological
mapping
in
30
esophagogastrectomy
specimens
of
middle
and
lower
esophageal
squamous
cell
carcinoma
.
We
measured
the
lengths
of
the
cardiac
mucosa
,
oxyntocardiac
mucosa
,
and
esophageal
cardiac
-
type
glands
.
We
assessed
the
presence
of
intestinal
metaplasia
,
pancreatic
acinar
cells
,
Brunner
'
s
-like
glands
,
and
submucosal
esophageal
gland
beneath
cardiac
mucosa
and
the
relationship
of
these
features
with
age
and
the
circumferential
location
of
cardiac
mucosa
.
The
lengths
of
cardiac
mucosa
and
esophageal
cardiac
-
type
glands
significantly
increased
with
age
(
<
63
years
,
2767
.
86
±
734
.
95
µm
vs
.
≥
63
years
,
5453
.
12
±
839
.
52
µm
,
P
=
0
.
025
and
<
63
years
,
1151
.
78
±
452
.
81
µm
vs
.
≥
63
years
,
2273
.
44
±
321
.
58
µm
,
P
=
0
.
049
,
respectively
)
and
the
presence
of
circumferential
cardiac
mucosa
(
+
,
5731
.
25
±
721
.
57
vs
.
-
,
2625
.
00
±
356
.
00
µm
,
P
=
0
.
007
;
+
,
2425
.
00
±
326
.
13
µm
vs
.
-
,
400
.
00
±
204
.
80
µm
,
P
<
0
.
0001
respectively
)
.
The
presence
of
intestinal
metaplasia
and
irregular
GEJ
increased
with
age
and
the
circumferential
location
of
cardiac
mucosa
.
The
presence
of
esophageal
submucosal
glands
beneath
the
cardiac
mucosa
,
pancreatic
acinar
cells
,
and
Brunner-like
glands
were
seen
in
8
/
30
(
26
.
7
%
)
,
15
/
30
(
50
%
)
,
and
14
/
30
(
46
.
7
%
)
cases
,
respectively
.
These
data
indirectly
suggest
that
cardiac
mucosa
originated
from
the
distal
esophagus
and
that
the
presence
of
cardiac
mucosa
may
indicate
GERD
,
in
accordance
with
data
from
Western
countries
.
Diseases
Validation
Diseases presenting
"esophageal submucosal glands beneath the cardiac mucosa"
symptom
esophageal squamous cell carcinoma
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