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№2' 2014
GASTROENTEROLOGYInternational Medical Journal, Vol. 20., Iss. 2, 2014, P. 25−28.
GASTROESOPHAGEAL REFLUX DISEASE AND ESOPHAGOGASTRIC JUNCTION ADENOCARCINOMA
Central Research Institute of Gastroenterology, Moscow, Russian Federation
Complicated structure of the esophgogastric junction mucosa is one of the causes of appearance of esophagus areas prone to malignant regeneration. There are several hypotheses of association of duodenogastroesophageal reflux containing acid, fatty acids, pancreatic enzymes, with development of metaplasia in the epithelium of the mucous membrane of the terminal esophagus, resembling the structure of the gastric cardia. According to one of them the epithelium of the cardia is always pathologically associated with gastroesophageal reflux disease, according to the other, this is a normal structure of the gastrointestinal tract epithelium. It is hypothesized that non−acid area in the region of the cardia is a barrier between the mucous membrane of the stomach and esophagus. Adenocarcinoma revealed endoscopically in the area of esophagogastric junction is a complex malignant tumor developed in the distal portion of the esophagus, cardia or proximal portion of the stomach. Cardial and noncardial cancers of the stomach having different etiology are distinguished. Increase of frequency of cancer of cardia and esophagogastric junction is influenced by increased acidity of the stomach. It is noted that common chronic atrophic gastritis with decreased acid formation in the stomach somewhat protects the organism from gastroesophageal reflux disease which can be an etiological factor in development of gastroesophageal junction cancer.
Key words: gastroesophageal reflux disease, duedenogastroesophageal reflux, adenocarcinoma, esophagogastric junction, etiology.