Document Detail

Inflammation and intestinal metaplasia of the gastric cardia: Helicobacter pylori, gastroesophageal reflux disease, or both.
MedLine Citation:
PMID:  10729733     Owner:  NLM     Status:  MEDLINE    
The gastric cardia is a microscopic zone that is normally found in the most proximal portion of the stomach, although cardiac-type mucosa may arise in the distal esophagus as a metaplastic phenomenon secondary to gastroesophageal reflux disease (GERD). Inflammation of the native gastric cardia is strongly associated with Helicobacter pylori infection, although there may be a second form of 'carditis' in which metaplastic cardiac-type mucosa becomes inflamed secondary to GERD. Intestinal metaplasia of the cardia may be difficult to recognize because of the difficulty in accurately identifying the esophagogastric junction by endoscopy and the histologic similarities of intestinal metaplasia in the proximal stomach and distal esophagus. However, cytokeratin 7 and 20 immunoreactivity patterns appear to be useful in distinguishing between these forms of intestinal metaplasia. The preponderance of data suggests that intestinal metaplasia of the cardia is associated with H. pylori infection as opposed to GERD, and preliminary data suggest a lower risk of progression to dysplasia and adenocarcinoma when compared to intestinal metaplasia of the distal esophagus.
J R Goldblum
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Digestive diseases (Basel, Switzerland)     Volume:  18     ISSN:  0257-2753     ISO Abbreviation:  Dig Dis     Publication Date:  2000  
Date Detail:
Created Date:  2000-08-08     Completed Date:  2000-08-08     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701186     Medline TA:  Dig Dis     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  14-9     Citation Subset:  IM    
Copyright Information:
Copyright 2000 S. Karger AG, Basel
Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Cardia / pathology*
Diagnosis, Differential
Gastric Mucosa / pathology*
Gastritis / etiology*,  pathology
Gastroesophageal Reflux / complications*,  pathology
Helicobacter Infections / complications*,  pathology
Metaplasia / etiology,  pathology

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