Gastric cardia

Since the 1970s, a rise in the incidence of adenocarcinoma of the cardia has occurred in the very populations in which the incidence of gastric cancer has been decreasing. Thus, there has been an emerging interest in exploring the pathology of this relatively ill-defined area of the stomach. Virtually all patients who have H.pylori gastritis in other regions of the stomach also have bacteria and inflammation in the region immediately distal to the gastroesophageal junction. Some patients, including those without H.pylori infection and patients with and without gastroesophageal reflux disease, have a localized inflammation of the cardia, commonly referred to as carditis. Intestinal metaplasia is found in the cardia of approximately 20% of patients with a variety of gastric disorders, even in the absence of H.pylori infection, and apparently also in healthy persons. The relationship between intestinal metaplasia in this location and adenocarcinoma of the junction remains unclear, but it is important to differentiate the intestinal metaplasia of the cardia from Barrett specialized epithelium. Cytokeratin and immunoreactive patterns may help to distinguish between intestinal metaplasia in long-segment Barrett esophagus and junctional metaplasia; conversely, the epithelium of short-segment Barrett esophagus may be impossible to separate from metaplasia originating in the cardia. Until the implications of such findings are clarified, it is advisable to collect as much specific information as possible carefully from each patient with changes at the gastroesophageal junction. Lesions of uncertain prognostic value today could acquire clinical significance when new knowledge is acquired.

THE RECOMMENDED LITERATURE

А. BASIC:

1. Harrison's Principles of Internal Medicine 16th Edition

2. Short Textbook of Medical Diagnosis and Management (third edition)/ Moxammed Inam Danish.-Department of Medicine, Medical Unite III, Dow Medical College and Civil Hospital Karachi, Pakistan, 2007. – 580 p.

3. Davidson’s Principles and practice of medicine (nineteenth edition)/Christopher Haslett, dvin R. Chilvers and others. – Edinburgh, 2007. – 1276 p.

4. Kelley's essentials of internal medicine/ editor-in-chief H.D. Humes . ─ 2nd ed. ─ Philadelphia : Lippincott Williams & Wilking, 2011.

5. Brochetr, A. Internal medicine subspecialties/ A. Brochert . ─ Philadelphia : Hanley & Belfus, 2006

6. Khrenov A.A. Therapy: Manual.— Simferopol, 2007.— 444 p.

B. ADDITIONAL:

Teacher recommends more monographic and periodical literature.

1. Burgener F.A., Kormano Martti. Differential diagnosis in computeredtomografhy. NewYork, Thiememed. publ. inc., 2006, 184-254.

2. The Merck Manual of Diagnosis and Therapy (seventeenth Edition)/ Robert Berkow, Andrew J. Fletcher and others. – published by Merck Research Laboratories, 2009.