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Journal of Gastrointestinal & Digestive System | ISSN: 2161-069X | Volume: 8
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October 29-30, 2018 | San Francisco, USA
International Conference on
Gastrointestinal Cancer and Therapeutics
4th World Congress on
Digestive & Metabolic Diseases
26th Annual Congress on
Cancer Science and Targeted Therapies
Current understanding of gastric cardiac carcinoma
Qin Huang
Harvard Medical School, USA
Gastric cardiac carcinoma (GCC) arises in the cardiac mucosa located primarily in the proximal stomach within 3cm below
the gastroesophageal junction. The 7th edition of the American Joint Committee on Cancer (AJCC7) staging scheme
classified this carcinoma as esophageal adenocarcinoma (EAC), which has been shown to be inadequate by recent research
results. The data from high-quality research papers show a rising incidence of GCC in East Asian countries, but a decreasing
trend in the West and a plateaued low level in the United States. The studies fromChina and Japan suggest a slow progression of
natural history in GCC, especially at the early stage. While risk factors and tumorigenesis mechanisms for GCC remain elusive,
histopathologic investigations demonstrate a wide histopathologic spectrumwith a predominance of the Lauren intestinal type
carcinoma and rare cancer types such as carcinosarcoma, adenosquamous and neuroendocrine carcinomas, and carcinoma
with lymphoid stroma, in contrast to a low frequency for poorly cohesive carcinoma including signet-ring cell carcinoma.
Because of heterogeneous post-resection patient survival characteristics, patient survival cannot be adequately stratified and
staged by the AJCC7 staging rules on the EAC. The recent results on genomic investigations of gastric and esophageal cancers
reveal a unique genetic profile in GCC with a predominance of a gastric chromosomal instability type, which is the same as
EAC, indicating the same molecular type for both EAC and GCC. The most recent multicenter study in 15 countries with
25411 radical gastrectomies exhibited a clear stratification of GCC patient prognosis with the staging rule for gastric cancer.
Thus, the updated AJCC 8th manual has reversed the staging role in AJCC7 and re-classified GCC as gastric cancer. These
outstanding progress have significantly advanced our understanding of GCC and direct future investigations to a new direction
with the goal to cure this potentially fatal cancer.
Biography
Qin Huang is a senior practicing pathologist with a strong interest in Gastrointestinal Cancer. Over the past 15 years, he has devoted most of his time and energy,
investigating cancer in the gastroesophageal junction region, including gastric cardiac carcinoma (GCC), Barrett’s esophagus, and esophageal adenocarcinoma
(EAC), and hereditary gastric cancer. He was the first to publish a study on the inadequacy of AJCC7 on staging of GCC, to indicate differences in clinicopathology
of cancers in the GEJ region between Chinese and Americans, to show the rarity of EAC in Chinese, to report a novel subtype of pancreatic-acinar-like
adenocarcinoma in the gastric cardia, and to describe unique clinicopathologic features of early GCC.
Qin Huang, J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C8-085