{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:39:19Z","timestamp":1775554759252,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2017,4,20]],"date-time":"2017-04-20T00:00:00Z","timestamp":1492646400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2017,4]]},"abstract":"Background and Aim<\/jats:title>Western studies have suggested two distinct etiologies of esophagogastric junction (EGJ<\/jats:styled-content>) cancer: Helicobacter pylori<\/jats:italic>\u2010associated atrophic gastritis and non\u2010atrophic gastric mucosa resembling esophageal adenocarcinoma. The present study investigated whether endoscopic gastric mucosal atrophy can distinguish between these two types of EGJ<\/jats:styled-content> adenocarcinoma.<\/jats:p><\/jats:sec>Methods<\/jats:title>Data were collected from patients with Siewert type II<\/jats:styled-content>, T1 EGJ<\/jats:styled-content> adenocarcinoma who underwent endoscopic or surgical resection at eight Japanese institutions in 2010\u20132015. Clinicopathological characteristics of EGJ<\/jats:styled-content> cancers with and without endoscopic gastric mucosal atrophy were compared. EGJ<\/jats:styled-content> was defined as the lower end of the palisade vein and\/or the top of the gastric folds.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 229 patients identified, 161 had endoscopic gastric mucosal atrophy and 68 did not. The latter group was younger (64 vs<\/jats:italic> 70\u00a0years, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.000); had a higher proportion of patients negative for H.\u00a0pylori<\/jats:italic> (90% vs<\/jats:italic> 47%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.0001); and had higher rates of gastroesophageal reflux disease symptoms (43% vs<\/jats:italic> 12%, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.017), mucosal breaks (25% vs<\/jats:italic> 15%, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.009), Barrett's esophagus (BE<\/jats:styled-content>, 78% vs<\/jats:italic> 42%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.0001), and tumors above the EGJ<\/jats:styled-content> (81% vs<\/jats:italic> 19%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.0001) and on the upper\u2010right side (74% vs<\/jats:italic> 38%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.0001) than the former group. Multivariate analysis showed that H.\u00a0pylori<\/jats:italic> positivity (odds ratio [OR<\/jats:styled-content>]\u00a0=\u00a013.0, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001), long\u2010segment BE<\/jats:styled-content> (OR<\/jats:styled-content>\u00a0=\u00a00.025, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.033), and longitudinal (OR<\/jats:styled-content>\u00a0=\u00a08.6, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.001) and circumferential (OR<\/jats:styled-content>\u00a0=\u00a04.7, P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.006) tumor locations were independently associated with gastric mucosal atrophy.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Two distinct types of EGJ<\/jats:styled-content> cancer were identified, with and without endoscopic gastric mucosal atrophy. These types were associated with different tumor locations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12849","type":"journal-article","created":{"date-parts":[[2017,4,20]],"date-time":"2017-04-20T10:08:53Z","timestamp":1492682933000},"page":"26-36","source":"Crossref","is-referenced-by-count":12,"title":["Endoscopic gastric mucosal atrophy distinguishes the characteristics of superficial esophagogastric junction adenocarcinoma"],"prefix":"10.1111","volume":"29","author":[{"given":"Noriya","family":"Uedo","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Yoshio","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo 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