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At least 127 records · Page 7Linked to original sources
PubMed1981

Perimeter and location of the muscular gastroesophageal junction or 'cardia' in control subjects and in patients with reflux esophagitis or achalasia.

The location and perimeter of the true muscular gastroesophageal junction or cardia were determined during operation in 6 patients with achalasia, in 20 control subjects, and in 40 patients with reflux esophagitis. These two latter groups were submitted to highly selective vagotomy, owing to duodenal ulcer in the control subjects and as part of the surgical technique in reflux esophagitis patients. The careful dissection and isolation of the distal 5-6 cm of the esophagus and esophagogastric junction permitted us to measure the location and perimeter very precisely. There was a very close correlation between the distance incisors-beginning of gastroesophageal sphincter measured preoperatively and the distance incisors-cardia measured during surgery. The cardia could be clearly identified by external inspection corresponding to the limit between the longitudinal muscle layer of the esophagus and the serosal surface of the stomach. The perimeter of the cardia in the patients with reflux esophagitis was significantly larger than the perimeter of the control subjects (p less than 0.001). Intraoperative manometry demonstrated that the external limit of the cardia corresponded to the beginning of the gastroesophageal sphincter. Patients with achalasia had significantly smaller perimeter than controls or reflux esophagitis patients (p less than 0.001).

Adult↗
PubMed2003

Alterations of p53 and PCNA in cancer and adjacent tissues from concurrent carcinomas of the esophagus and gastric cardia in the same patient in Linzhou, a high incidence area for esophageal cancer in northern China.

AIM: To characterize the alteration and significance of p53 and PCNA in cancer and adjacent tissues of concurrent cancers from the esophagus and gastric cardia in the same patient. METHODS: P53 and PCNA protein accumulation in 25 patients with concurrent cancers from the esophagus and gastric cardia (CC, concurrent carcinomas of esophageal squamous cell carcinoma and gastric cardia adenocarcinoma) were detected by immunohistochemical method (ABC). RESULTS: In CC patients, both esophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma (GCA) tissues showed different positive immunostaining extent of p53 and PCNA protein (P>0.05). The positive immunostaining rates for p53 and PCNA were 60 % (15/25) and 92 % (23/25), respectively in SCC; and 40 % (10/25) and 88 % (22/25), respectively in GCA. "Diffuse" immunostaining pattern was frequently observed in both p53 and PCNA. High coincidence rates for p53 and PCNA positive staining were observed in SCC and GCA from the same patients, and accounted for 56 % and 96 %. In SCC patients, with the lesions progressed from normal esophageal epithelium (NOR) to basal cell hyperplasia (BCH) to dysplasia (DYS) to carcinoma in situ (CIS) to SCC, the positive rates for p53 were 27 %, 50 %, 50 %, 29 % and 72 %, and 55 %, 70 %,75 %, 71 % and 93 % for PCNA, respectively. In GCA, with the lesions progressed from normal gastric cardia epithelium to DYS to CIS to GCA, the positive rates of p53 expression were 44 %, 27 %, 22 % and 36 % respectively, the difference was not significant; the positive rates of PCNA protein expression were 67 %, 64 %, 67 % and 86 %, respectively. The chi(2) test, Fisher's Exact Test, Mantel-Haenszel chi(2) Test and Kappa Test were used for the statistics. CONCLUSION: The high coincident alterations for P53 and PCNA in SCC and GCA from the same patient indicate the possibility of similar molecular basis, which provides important molecular basis and etiological clue for similar geographic distribution and risk factors in SCC and GCA.

Adenocarcinoma↗
PubMed1999

Association between body mass and adenocarcinoma of the esophagus and gastric cardia.

BACKGROUND: The incidence of esophageal and gastric cardia adenocarcinoma is, for unknown reasons, increasing dramatically. A weak and inconsistent association between body mass index (BMI) and adenocarcinoma of the esophagus and gastric cardia has been reported. OBJECTIVE: To reexamine the association between BMI and development of adenocarcinoma of the esophagus and gastric cardia. DESIGN: Nationwide, population-based case-control study. SETTING: Sweden, 1995 through 1997. PATIENTS: Patients younger than 80 years of age who had recently received a diagnosis were eligible. Comprehensive organization ensured rapid case ascertainment. Controls were randomly selected from the continuously updated population register. Interviews were conducted with 189 patients with adenocarcinoma of the esophagus and 262 patients with adenocarcinoma of the gastric cardia; for comparison, 167 patients with incident esophageal squamous-cell carcinoma and 820 controls were also interviewed. MEASUREMENTS: Odds ratios were determined from BMI and cancer case-control status. Odds ratios estimated the relative risk for the two adenocarcinomas studied and were calculated by multivariate logistic regression with adjustment for potential confounding factors. RESULTS: A strong dose-dependent relation existed between BMI and esophageal adenocarcinoma. The adjusted odds ratio was 7.6 (95% CI, 3.8 to 15.2) among persons in the highest BMI quartile compared with persons in the lowest. Obese persons (persons with a BMI > 30 kg/m2) had an odds ratio of 16.2 (CI, 6.3 to 41.4) compared with the leanest persons (persons with a BMI < 22 kg/m2). The odds ratio for patients with cardia adenocarcinoma was 2.3 (CI, 1.5 to 3.6) in those in the highest BMI quartile compared with those in the lowest BMI quartile and 4.3 (CI, 2.1 to 8.7) among obese persons. Esophageal squamous-cell carcinoma was not associated with BMI. CONCLUSIONS: The association between BMI and esophageal adenocarcinoma is strong and is not explained by bias or confounding. The carcinogenic mechanism, however, remains to be clarified. The increasing prevalence of obesity in western countries could be important in understanding the increasing occurrence of this tumor.

Adenocarcinoma↗
PubMed2001

[Esophageal implantation metastasis from adenocarcinoma of the cardia].

A 74 years old male patient was admitted to our department suffering from dysphagia for five months. Gastric Barium studies showed a cardia tumour with polypoid lesions in the wall of the esophagus, and gastro-esophageal reflux disease was also diagnosed. Endoscopy verified a cardia tumour with esophageal metastasis, and biopsy was obtained from the two lesions. Histology showed that both tumours were adenocarcinomas. Endoscopic ultrasonography classified the cardia tumour as grade T2. As observed during endoscopy, the wall of the esophagus at the level of the polypoid lesion was hypo-echogenic and thick which was result of thickened mucosa. Total gastrectomy and oesophagectomy was performed. Pathology showed that the cardia tumour was pT2N2 and type Siewert-Stein II. The esophageal polypoid lesion was also proved an adenocarcinoma, which was localized only to the mucosa. No tumour cells were found in the blood- or in lymph vessels between the tumour and the esophageal adenocarcinoma. We think that the polypoid adenocarcinoma in the esophagus is an esophageal metastasis implantation from the cardia adenocarcinoma. It is based on the exclusion of other possible tumour dissemination routes. Probably the gastro-esophageal reflux is responsible for the implantation of tumour cells.

Adenocarcinoma↗
PubMedDate not supplied

The influence of surgical volume on hospital mortality and 5-year survival for carcinoma of the oesophagus and gastric cardia.

OBJECTIVE: To study the effects of hospital operation volume on hospital mortality and 5-year survival in patients treated with resection for carcinoma of the oesophagus and gastric cardia. INTRODUCTION: Surgery due to tumours of the oesophagus and gastric cardia is probably associated with the highest postoperative morbidity and mortality of all elective surgical procedures. Concentration to high-volume centres has been suggested to improve the outcome. MATERIALS AND METHODS: Between 1987 and 1996, all patients with squamous cell carcinoma or adenocarcinoma of the oesophagus or gastric cardia were identified from the Swedish Cancer Registry and the Swedish Hospital Discharge Registry. The study population was assessed according to patients operated at hospitals with a low (L-V), intermediate (I-V) or high operation volume (H-V), defined as <5 resections/year, 5-15 resections/year and >15 resections/year, respectively. We analyzed hospital mortality and 5-year survival. RESULTS: During the study period, 1429 patients were treated with resection for carcinoma of the oesophagus (n=665) or the gastric cardia (n = 764). A total of 74 hospitals were registered with at least one surgical resection, of which 90% performed <5 resections/year. The distribution of gender and age was comparable in the three groups. Hospital mortality was 10.4, 6.3 and 3.5% in the L-V, I-V and H-V groups, respectively. Overall 5-year survival was 17% (L-V), 19% (I-V) and 22% (H-V). Multivariate analysis showed an improved long-term survival for patients operated at H-V compared to L-V hospitals (p=0.02). CONCLUSION: This study supports an inverse relationship between hospital volume and hospital mortality after surgical tumour resection of the oesophagus or gastric cardia. Overall 5-year survival was significantly higher at high-volume hospitals compared to low-volume centres. We believe that concentrating these patients in high-volume hospitals is necessary to achieve high quality surgical treatment and to facilitate research aiming to improve prognosis.

Adenocarcinoma↗
PubMedDate not supplied

Allelic imbalance on distal 7q (7q36.1-q36.3) in gastric cardia and oesophageal (Barrett's) adenocarcinoma.

BACKGROUND: Oesophageal (Barrett's) and gastric cardia adenocarcinomas are cancers arising at and around the gastro-oesophageal junction. The prognosis is poor, since detection is usually at a late stage and metastatic spread occurs early. MATERIALS AND METHODS: We investigated the 7q region with a set of 5 polymorphic markers spanning 7q36.1-q36.3 in 33 Barrett-related carcinomas. In addition, 40 gastric cardia cancers were investigated to compare the pattern of imbalance at these loci. RESULTS: Overall, the number of allelic loss was higher in Barrett's cancers than in gastric cardia carcinomas (p=0.04). In Barrett's adenocarcinomas, imbalance varied from 28% to 45% (of informative cases) with the highest prevalence at marker D7S483. In gastric cardia cancers, loss ranged from 12% to 27% (of informative cases), being most frequent at marker D7S3037. The difference between oesophageal and gastric adenocarcinomas was highest for polymorphic marker D7S483 (p=0.05). CONCLUSION: Marker D7S483 can aid in discriminating oesophageal (Barrett's) and gastric cardia carcinomas. Further, this region possibly harbours cancer gene(s) involved in Barrett-related adenocarcinomas.

Adenocarcinoma↗
PubMed2006

[Clinical analysis of 123 gastric cardia carcinoma patients treated with surgical operation].

BACKGROUND & OBJECTIVE: The prevalence of gastric cardia carcinoma is increasing in recent decades, necessitating further research on it. However, there are still debates on its clinical management. This study was to summarize our experiences in surgical treatment of gastric cardia carcinoma. METHODS: A total of 123 gastric cardia carcinoma patients, received surgical operation, were divided into 3 groups according to surgical approaches: 72 in thoracic group, 40 in abdominal group, and 11 in thoracoabdominal group. Clinical data, including preoperative examination, surgical approach, lymph node dissection, and postoperative pathology, of the patients were analyzed. RESULTS: Setting pathologic results as golden standard, the correct diagnosis rates of preoperative ultrasound for serosal involvement, lymph node metastasis, distal esophageal involvement, and others (including liver metastases, extended invasion, and ascites) were 71.2%, 62.2%, 47.8%, and 100%, respectively; those of CT were 78.6%, 72.7%, 51.9%, and 100%, respectively. Endoscopy could indicate the distance between tumor and incisor, and barium meal showed the relationship between tumor and diaphragm. The curative resection rate was 94.3% (116/123); among the 116 cases, 108 (93.1%) were adenocarcinoma, 2 were squamous cell carcinoma, 2 were adenosquamous carcinoma, 2 were atypical carcinoid, and 2 were carcinoid; 84 (72.4%) had abdominal lymph node metastases, 6 (7.1%) had thoracic lymph node metastases, and 40 (34.5%) had distal esophageal involvement. CONCLUSIONS: Preoperative abdominal ultrasound and thoracoabdominal CT scan are helpful in evaluating respectability of gastric cardia carcinoma. Endoscopy and barium meal may be helpful in deciding the surgical approach. Abdominal lymph node is the main route of lymphatic dissemination of gastric cardia carcinoma. The efficacies of the 3 surgical approaches are similar; each has its benefit. Surgical modalities should be carried out individually according to Siewert classification and patient's conditions.

Adenocarcinoma↗
PubMed1989

Eructation of gas through the gastroesophageal sphincter before and after limiting distension of the gastric cardia or infusion of a beta-adrenergic amine in dogs.

Gas eructation function of the gastroesophageal sphincter (GES) was investigated in 6 conscious dogs before and after a sleeve was placed around the GES and gastric cardia and during IV infusion of a beta-adrenergic amine (epinephrine). To induce eructation, nitrogen gas was insufflated (351.4 +/- 2 ml/min; mean +/- SEM) into the stomach through 1 channel of a 4-lumen catheter. After baseline studies and epinephrine infusion studies were completed in each dog, surgery was done to limit partially gastric distension by intraluminal contents by placing a silicone rubber sleeve around the GES and the first few centimeters of the cardia. Gastroesophageal sphincter pressure was 31.8 +/- 2.2 mm of Hg in baseline studies, 17.3 +/- 1.3 mm of Hg during epinephrine infusion (P. less than 0.003), and 30.3 +/- 2.2 mm of Hg after the sleeve was placed around the GES and cardia. During insufflation, gastric pressures before eructation increased to 5.74 +/- 0.41 mm of Hg before and to 15.15 +/- 1.63 mm of Hg after cardia sleeve placement (P less than 0.001). Eructation occurred at intervals of 1.83 +/- 0.41 minutes before cardia sleeve placement, and eructations were not observed with the sleeve in place. Before the sleeve was placed, administration of epinephrine resulted in an eructation interval of 0.84 +/- 0.09 minutes, which was significantly different from that in the same dogs given no drugs (P less than 0.004).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

[On the lymphatics of the cardia--with special reference to the study of using endoscopic lymphoscintigraphy with SPECT].

Endoscopic lymphoscintigraphy was performed on 29 patients. In 15 of 29 cases, Single Photon Emission Computed Tomography (SPECT) was performed to observe the lymphatics of the cardia. The rate of detection of paraaortic lymph nodes by SPECT was 66.6%, and in particular the paraaortic lymph nodes in the upper portion of the left renal vein were detected at a rate of 58.3%. The ascending lymph flow from the cardia to the mediastinum could be depicted by SPECT. The SPECT images and the distribution of accumulation of Tc-99m Rhenium colloid into the regional lymph nodes indicated a similar tendency to the actual metastatic rate of carcinoma of the cardia. Endoscopic lymphoscintigraphy with SPECT is considered to be useful for imaging the lymph flow from the cardia to the regional lymph nodes. On the other hand, the conventional planar image was poor in depicting lymph nodes, and was impossible in dynamic analysis. In the early stage of carcinoma of the cardia, if the area limited, proximal gastrectomy seems reasonable, but in progressive and deepseated cancer, it is suggested that it is necessary to remove the lymph nodes in a wide area, including the paraaortic lymph nodes, in addition to performing total gastrectomy.

Adenocarcinoma↗
PubMedDate not supplied

Study of the lymph flow of the cardia by endoscopic RI-lymphography with SPECT.

Endoscopic RI-lymphography was performed in 29 patients, with single photon emission computed tomography (SPECT) also performed in 19 of them. The lymph flow from the cardia was directly evaluated in lymphograms and compared with the RI uptake of each lymph node and the incidence of lymph node metastasis of previously resected carcinoma of the cardia in patients according to the location of the lymph node. Endoscopic RI-lymphography performed in combination with SPECT was considered to be highly useful for imaging lymph flow of the cardiac region. SPECT and RI-lymphography indicated rich lymph flow from the cardia to the periaortic region, and this finding was consistent with the incidence of lymph node metastasis according to the location of the lymph node in patients who had previously undergone resection of cancer of the cardia. Careful examination for metastasis to lymph nodes around the abdominal aorta was considered to be necessary, especially in patients with carcinoma of the cardia.

Cardia↗
PubMed1995

Carcinoma of the gastric cardia.

The general term "carcinoma of the gastric cardia" includes three different types of adenocarcinomas. Carcinoma of the distal oesophagus (Type I), true carcinoma of the cardia (Type II) and subcardial gastric carcinoma (Type III). The preoperative classification of these carcinomas of the gastro-oesophageal junction is primarily based on radiologic and endoscopic examination. The most accurate method for preoperative staging is endosonography; if this shows that complete tumour resection is not possible, preoperative chemotherapy for downstaging of the tumour is suggested. As the serosal cover on the back wall of the cardia and the gastric fundus is lacking, the Union Internationale Contre le Cancer (UICC) pT2 classification includes wall penetrating tumours which would be equivalent to pT3 in other parts of the stomach. For prognostic reasons these advanced carcinomas should be classified as pT2b in contradistinction to tumours limited to the muscularis propria (pT2a). The results of surgical resection of 445 carcinomas of the gastric cardia are presented (Type I 38%, Type II 28%, Type III 34%). The overall 30-day and 90-day mortality rates were 4.9% and 10.4%, respectively. Long term survival after resection of carcinoma of the gastric cardia was mainly associated with complete tumour removal, limited wall penetration and absence of lymph node metastases. Patients with Type I cancers showed a tendency for a better outcome compared to Type II and III because of a higher percentage of early cancers and a higher rate of complete tumour resection.

Adenocarcinoma↗
PubMed1998

[Pathology of the cardia].

Defining the cardia as consisting of 2 cm of the distal esophagus and 2 cm of the proximal stomach, we describe the detailed histopathological features of the cardia and esophagogastric junction (EGJ). The distance between the EGJ and the squamocolumnar junction (SCJ) was 0-10 mm (mean: 3 mm) in 50 Japanese autopsy cases, but the SCJ was not located below the EGJ. It has been reported that pancreatic metaplasia, small leiomyomas, inflammatory EGJ polyps, carditis, and Barrett's epithelium are often recognizable in the cardia, and the literature on these conditions is reviewed. The relationship between leiomyomas and gastrointestinal stromal tumors is also reviewed, and the histopathology of short-segment Barrett's esophagus is described. In biopsy specimens obtained from Barrett's esophagus, the presence of ducts of esophageal glands proper in the metaplastic mucosa as revealed by microscopy can be used to establish the diagnosis, although only in a short-segment of Barrett's esophagus less than 3 cm in length. Finally, several English and Japanese textbooks on the pathology of the digestive tract containing descriptions of normal and diseased cardia are described for the convenience of authors writing scientific papers on diseases of the cardia.

Aged↗
PubMed2002

Occupation and risk of esophageal and gastric cardia adenocarcinoma.

BACKGROUND: Adenocarcinomas of the esophagus and gastric cardia have risen dramatically in incidence over the past few decades, however, little research has been conducted on the occupational risk factors for these cancers. METHODS: In this population-based case-control study, lifetime job histories were compared between cases of esophageal adenocarcinoma (n = 283), gastric cardia adenocarcinoma (n = 259), and population controls (n = 689). Odds ratios (OR) and 95% confidence intervals (CI) for ever employment and by duration in various occupational and industrial categories were calculated using unconditional logistic regression. RESULTS: The risk of esophageal adenocarcinoma was elevated for persons ever employed in administrative support (OR = 1.5; 95%CI = 1.0-2.1); financial, insurance, and real estate (OR = 1.6; 95%CI = 1.0-2.4); and health services (OR = 2.2; 95%CI = 1.2-3.9). The risk of gastric cardia adenocarcinoma was increased among transportation workers (OR = 1.7; 95%CI = 1.1-2.6), as well as among carpenters (OR = 1.8; 95%CI = 0.9-3.9) and workers in the furniture manufacturing industry (OR = 2.4; 95%CI = 0.9-6.3). However, we observed few duration-response relations between length of employment in any category and cancer risk. CONCLUSIONS: This study revealed associations of esophageal adenocarcinoma with employment in administrative support, health services, and a category of financial, insurance, and real estate industries, and of gastric cardia adenocarcinoma with transportation and certain woodworking occupations. Some of these findings may be due to the play of chance associated with the multiple comparisons made in this study. Our results suggest that, overall, workplace exposures play a minor role in the etiology and upward trend of esophageal and gastric cardia adenocarcinomas.

Adenocarcinoma↗
PubMed2001

Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery.

BACKGROUND & AIMS: Gastroesophageal reflux has been proposed as an important risk factor for esophageal and gastric cardia adenocarcinoma, but prospective data are lacking. Furthermore, the effect of antireflux surgery has not yet been studied. We conducted a population-based retrospective cohort study to fill these gaps. METHODS: A cohort of 35,274 male and 31,691 female patients with a discharge diagnosis of gastroesophageal reflux diseases, and another cohort of 6406 male and 4671 female patients who underwent antireflux surgery, were identified in the Swedish Inpatient Register. Follow-up was attained through record linkage with several nationwide registers. Standardized incidence ratio (SIR) was used to estimate relative risk of upper gastrointestinal cancers, using the general Swedish population as reference. RESULTS: After exclusion of the first year follow-up, 37 esophageal and 36 gastric cardia adenocarcinomas were observed among male patients who did not have surgery (SIR, 6.3, 95% confidence interval [CI], 4.5-8.7; SIR, 2.4, 95% CI, 1.7-3.3, respectively). SIR for esophageal adenocarcinoma increased with follow-up time (P = 0.03 for trend). Among male patients who had undergone antireflux surgeries, risks were also elevated (16 esophageal adenocarcinoma, SIR, 14.1, 95% CI, 8.0-22.8; 15 gastric cardia adenocarcinomas, SIR, 5.3, 95% CI, 3.0-8.7) and remained elevated with time after surgery. The cancer risk pattern in women was similar to that for men, but the number of cases were much smaller. CONCLUSIONS: Gastroesophageal reflux is strongly associated with the risk of esophageal adenocarcinoma, and to a lesser extent, with gastric cardia adenocarcinoma. The risk of developing adenocarcinomas of the esophagus and gastric cardia remains increased after antireflux surgery.

Adenocarcinoma↗
PubMed1995

Can pulmonary aspiration of gastric contents be prevented by balloon occlusion of the cardia? A study with a new nasogastric tube.

Rapid-sequence induction of anesthesia and the application of cricoid pressure are the two most common maneuvers performed when patients requiring general anesthesia are at risk of pulmonary aspiration. However, these procedures are quite elaborate and entail risks and dangers in themselves. A new disposable nasogastric balloon tube was developed to prevent the reflux of gastric contents by blocking the cardia with a balloon. The effectiveness of this tube was investigated in animals and healthy volunteers. In addition, we describe the initial experience with the tube during ventilation via a mask in patients with an increased risk of aspiration. Twelve pigs with a blocked cardia did not show any gastroesophageal reflux under six different procedures to provoke vomiting and regurgitation (gastric fluid filling with different volumes, head-down positioning, drug-induced vomiting, external gastric compression before and after surgical ligation of the pyloric orifice), whereas 37 of 48 provocation maneuvers led to a reflux in eight additional pigs with an unblocked cardia. In 26 test subjects with a blocked cardia, reflux of gastric contents was not observed when vomiting was provoked. After elimination of the cardia blockade, a reflux could be triggered in 24 of the 26 subjects. Among 42 patients in danger of aspiration, anesthesia could be induced without any problems using a nasogastric balloon tube with ventilation via a mask. The present experimental findings in animals and test subjects show that the nasogastric balloon tube can prevent gastroesophageal reflux under provocation of vomiting and regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Tumor suppressor gene p16 and Rb expression in gastric cardia precancerous lesions from subjects at a high incidence area in northern China.

AIM: To further understand the molecular basis for gastric cardia carcinogenesis and to provide etiological clues. METHODS: Endoscopic mucosa biopsy and histopathological examinations were made on 37 subjects from a high incidence area for both esophageal and gastric cardia carcinomas in northern China. All the biopsy samples were fixed in 850 ml. (-1)L alcohol and embedded in paraffin. Each block contained one piece of tissue and was serially section at 5 microm. Immunohistochemistry (ABC) was carried out on these gastric cardia samples to determine the alterations of p16 and Rb. RESULTS: Based on the histopathlogical examination there were 11 cases of chronic superficial gastritis, 12 cases of chronic atrophic gastritis and 14 cases of dysplasia. The immunostaining demonstrated different levels of unclear immunostaining of p16 and Rb in normal gastric cardia tissue and the tissues with different severity of lesions. With the lesions progressing, the positive immunostaining rates for p16 protein had a decreasing tendency. In contrast, the positive immunostaining rate for Rb protein had an increasing tendency. There was a significant negative relationship between the two parameters. Changes of p16 was CSG 11(100%), CAG 7(58%), DYS 4(29%) and changes of Rb was CSG 2(18%), CAG 8(67%) and DYS 12(86%), (P<0.05). CONCLUSION: The alterations of p16 and Rb protein may play a role in the early stages of gastric cardia carcinogenesis.

China↗
PubMedDate not supplied

Balloon dilatation in achalasia cardia.

Treatment of achalasia cardia by pneumatic dilatation is an established method. However, data on results of pneumatic dilatation in Indian patients with achalasia cardia are scarce. We report our experience with treatment of achalasia cardia by pneumatic dilatation in 38 patients. The diagnosis of achalasia cardia was based on clinical examination, barium swallow and upper gastrointestinal (GI) endoscopy. Twenty nine (76.3%) patients improved with first dilatation, 8 (21%) patients had to undergo second dilatation and 1 (2.6%) required a third. Most of the patients remained asymptomatic during a follow-up of 6 months to 6 years. Immediate and late complications occurred in 5 (13%) and 2 (5.2%) patients, respectively. Thus, pneumatic dilatation is a simple, safe and effective method for treating Indian patients with achalasia cardia.

Adolescent↗
PubMed2002

Endoscopic study on cancer of gastric cardia in the high incidence areas of China.

OBJECTIVE: Endoscopy was used to study the high incidence area of cancer of gastric cardia. METHODS: 417 patients with early cardiac cancer and 451 patients with advanced lesions were analyzed to the high incidence point of cardiac cancer. Verifying endoscopic screening of 205 subjects was performed later in the high incidence area of esophageal cancer. RESULTS: 327 of 417 (78.4%) of early cardiac cancer patients and 336 of 451 (74.5%) of advanced lesions were proved to have developed their origin at the root of the mucosal fold in the gastric cardia. Eleven cardiac cancer patients were found by the verifying endoscopic screening, among whom 9 patients (81.8%) developed the primary focus at the root of mucosal fold in the cardia. CONCLUSION: The root of mucosal fold in the gastric cardia is proved to be the high incidence point of cancer of gastric cardia, which is very important clinically.

China↗