@entity420 of the distal esophagus and esophagogastric junction continues to rise in incidence. An @entity1944 (Barrett esophagus)- @entity1141 -carcinoma sequence induced by @entity354 is well established. However, a significant number of @entity420 in the vicinity of the esophagogastric junction are seen in the background of @entity299 without @entity1944 . Thus, the aim of this study was to investigate the role of Barrett esophagus ( @entity1944 ) in the classification and prognosis of @entity5 of the distal esophagus and esophagogastric junction. Clinicopathological and molecular characteristics were examined in 157 consecutively resected @entity420 of the distal esophagus and esophagogastric junction and were compared between @entity5 arising in association with intestinal-type and @entity299 . @entity420 were more likely to be associated with younger age (P=0.0057), reflux symptoms (P<0.0001), proximal location (P=0.0009), lower T stage (P<0.0001), fewer nodal metastases (P=0.0001), absence of @entity353 . Histologically, @entity4056 were more likely to be low-grade glandular @entity5 (P=0.0095) of intestinal or mixed immunophenotype (P=0.015) and express nuclear @entity3546 (P=0.0080), whereas @entity5 arising in a background of @entity299 were more frequently associated with @entity470 amplification (P=0.0051). Five-year overall survival rate was significantly higher in @entity1 with @entity4056 (28 vs 9%, P=0.0015), although no survival benefit was seen after adjusting for potential confounders. Our findings support the theory that multiple distinct pathways of tumorigenesis exist in the vicinity of the esophagogastric junction, including one in which @entity5 arise from @entity1944 (intestinal pathway), and one potentially involving @entity1141 of the @entity299 (non-intestinal pathway). Additional studies are warranted to further clarify their pathogenesis and the molecular mechanisms involved.

The dichotomy in carcinogenesis of the distal esophagus and esophagogastric junction: intestinal-type vs XXXX -associated @entity420 .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1944 :: ('MESH:D007410', 'Disease') :: ['dysplastic intestinal metaplasia', 'intestinal-type mucosa', 'intestinal metaplasia'] @entity353 :: ('MESH:D015431', 'Disease') :: ['lymphatic (P<0.0001), venous (P=0.0060) or perineural (P<0.0001) invasion'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity470 :: ('1956', 'Gene') :: ['EGFR'] @entity4056 :: ('MESH:D007414', 'Disease') :: ['intestinal-type mucosa-associated tumors'] @entity3546 :: ('1499', 'Gene') :: ['b-catenin'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux disease'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac-type mucosa', 'gastric/cardiac-type mucosa'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinomas', 'Intestinal-type mucosa-associated adenocarcinomas', 'Adenocarcinoma'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity299 :: (MESH:D006331,Disease) :: ['cardiac-type mucosa']
