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The pathology of gastric cardia: a prospective, endoscopic, and morphologic study.
Am J Surg Pathol 2007; 31(5):706-10AJ

Abstract

"Carditis" (inflammation of the gastric cardiac mucosa) may be associated with gastroesophageal reflux disease (GERD), whereas other studies argue that Helicobacter pylori could play a significant role in the chronic cardiac damage. We examined prospectively histologic features of gastric cardia, esophagitis, and H. pylori status in 204 consecutive subjects with GERD symptoms (57.3% male, 42.7% female mean age 49.2 y) undergoing upper gastrointestinal endoscopy with multiple biopsies in the distal esophagus, cardiac region, and stomach. These were assessed for esophagitis landmarks [Ismail Beigi grading (g0-3)], gastritis, and H. pylori infection (Sydney classification). The average symptom duration was 10.8 months. Endoscopy showed no erosive disease in 54.5% patients, grade "A" esophagitis in 37.6%, "B" in 8%, and "C" in 1 case. Histologic examination disclosed g0 in 8.3% patients, g1 in 78.4%, g2 in 12.8%, and g3 in 1; analysis of the cardia showed oxyntic mucosa in 27.9% patients and chronic cardiac mucosa inflammation in 72.1%. Carditis was significantly related to macroscopic esophagitis (P=0.044) and heartburn score (P=0.001). H. pylori cardiac infection was present in 27.4% cases (73.2% associated with cardiac mucosa). Gastric H. pylori infection was demonstrated in 35% patients. H. pylori in the cardiac region was associated with gastric H. pylori infection (P=0.001) and with paucity of GERD symptoms (P=0.05). A good correlation between carditis and GERD, concerning symptoms and macroscopic esophagitis was found in this study. H. pylori-related carditis is likely to be differently compared with the GERD-related type.

Authors+Show Affiliations

Surgical Endoscopy Unit, Department of Clinical and Experimental Medicine, University of Perugia School of Medicine, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17460453

Citation

Cestari, Renzo, et al. "The Pathology of Gastric Cardia: a Prospective, Endoscopic, and Morphologic Study." The American Journal of Surgical Pathology, vol. 31, no. 5, 2007, pp. 706-10.
Cestari R, Villanacci V, Bassotti G, et al. The pathology of gastric cardia: a prospective, endoscopic, and morphologic study. Am J Surg Pathol. 2007;31(5):706-10.
Cestari, R., Villanacci, V., Bassotti, G., Rossi, E., Casa, D. D., Missale, G., ... Genta, R. M. (2007). The pathology of gastric cardia: a prospective, endoscopic, and morphologic study. The American Journal of Surgical Pathology, 31(5), pp. 706-10.
Cestari R, et al. The Pathology of Gastric Cardia: a Prospective, Endoscopic, and Morphologic Study. Am J Surg Pathol. 2007;31(5):706-10. PubMed PMID: 17460453.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pathology of gastric cardia: a prospective, endoscopic, and morphologic study. AU - Cestari,Renzo, AU - Villanacci,Vincenzo, AU - Bassotti,Gabrio, AU - Rossi,Elisa, AU - Casa,Domenico Della, AU - Missale,Guido, AU - Minelli,Luigi, AU - Cengia,Paolo, AU - Gambarotti,Marco, AU - Pirali,Francesco, AU - Donato,Francesco, AU - Genta,Robert M, PY - 2007/4/27/pubmed PY - 2007/6/1/medline PY - 2007/4/27/entrez SP - 706 EP - 10 JF - The American journal of surgical pathology JO - Am. J. Surg. Pathol. VL - 31 IS - 5 N2 - "Carditis" (inflammation of the gastric cardiac mucosa) may be associated with gastroesophageal reflux disease (GERD), whereas other studies argue that Helicobacter pylori could play a significant role in the chronic cardiac damage. We examined prospectively histologic features of gastric cardia, esophagitis, and H. pylori status in 204 consecutive subjects with GERD symptoms (57.3% male, 42.7% female mean age 49.2 y) undergoing upper gastrointestinal endoscopy with multiple biopsies in the distal esophagus, cardiac region, and stomach. These were assessed for esophagitis landmarks [Ismail Beigi grading (g0-3)], gastritis, and H. pylori infection (Sydney classification). The average symptom duration was 10.8 months. Endoscopy showed no erosive disease in 54.5% patients, grade "A" esophagitis in 37.6%, "B" in 8%, and "C" in 1 case. Histologic examination disclosed g0 in 8.3% patients, g1 in 78.4%, g2 in 12.8%, and g3 in 1; analysis of the cardia showed oxyntic mucosa in 27.9% patients and chronic cardiac mucosa inflammation in 72.1%. Carditis was significantly related to macroscopic esophagitis (P=0.044) and heartburn score (P=0.001). H. pylori cardiac infection was present in 27.4% cases (73.2% associated with cardiac mucosa). Gastric H. pylori infection was demonstrated in 35% patients. H. pylori in the cardiac region was associated with gastric H. pylori infection (P=0.001) and with paucity of GERD symptoms (P=0.05). A good correlation between carditis and GERD, concerning symptoms and macroscopic esophagitis was found in this study. H. pylori-related carditis is likely to be differently compared with the GERD-related type. SN - 0147-5185 UR - https://www.unboundmedicine.com/medline/citation/17460453/The_pathology_of_gastric_cardia:_a_prospective_endoscopic_and_morphologic_study_ L2 - http://dx.doi.org/10.1097/PAS.0b013e31802c9dd5 DB - PRIME DP - Unbound Medicine ER -