CHSJ

Curr Health Sci J, vol. 36, no. 3, 2010

Pathogenesis of esogastric junction cancer

[Review]

C.M. DOCHIT(1), C. SIMIONESCU(2), C. GRUIA(1), R. TASLACA(3), D. STANCULESCU(4)


(1)Laboratory of Pathology, Emergency County Hospital Craiova;
(2)Department of Morphopathology, University of Medicine and Pharmacy Craiova;
(3)Laboratory of Pathology, Municipal Hospital Turnu Magurele;
(4)Laboratory of Pathology, Tg-Carbunesti Hospital


Abstract:

Introduction: Adenocarcinomas of esogastric junction are divided in three subgroups according to their relation with proximal extremity and gastric folds: AEG I – cancers of distal oesophagus; AEG II – cancers of true cardio; AEG III – sub-cardiac cancers. AEG I and AEG II are considered the same descriptive entity, being similar from the point of view of the patients’characteristics (fatness, medium-aged white men suffering from reflux illness without gastritis with Helicobacter Pylori), of the incidental tendencies and of molecular profile. Predisposing factors: genetic predisposition for the development of carcinomas on the bottom of Barrett oesophagus is supported by the fact that these ones affect almost exclusively the white men. There are familiar forms of the illness, where there were indentified polymorphisms and genetic alterations associated to adenocarcinomas of esogastric junction. As risky factors, there have been incriminated: gastro-oesophageal reflux illness, fatness, hiatal hernia, prematurity, smocking, alcohol consumption. Pathogenesis of esogastric junction cancers developed on the bottom of Barrett oesophagus which represents a premalignant condition that arises on the bottom of the long term gastro-oesophageal reflux illness, its formation implying at least three different phases. The progression towards malignity inside Barrett oesophagus is a multistep process, implying the transition from metaplasia to low degree dysplasia, to high degree dysplasia and invasive carcinoma. Conclusions: as the formation of the adenocarcinoma on the bottom of Barrett oesophagus represents a multiphase process, implying the transition from metaplasia to low degree dysplasia, to high degree dysplasia and invasive carcinoma, it is important that the patients with Barrett oesophagus should be carefully supervised, in order to diagnose the carcinoma from an early phase.


Keywords: esogastric junction, Barrett oesophagus, adenocarcinoma



Corresponding: C.M. Dochit, MD, PhD Student, Laboratory of Pathology, Emergency County Hospital Craiova, 1. Tbaci St. 200456; Craiova, Dolj: e-mail dochitcorina@yahoo.com


DOI 10.12865/CHSJ.36.03.02 - Download PDF
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