Pathologic Risk Factors of Adenocarcinoma of the Gastric Cardia and Gastroesophageal Junction

Available evidence supports the existence of two major pathways of neoplastic development in the gastroesophageal region: the Barrett pathway, related to GER disease, and the gastric pathway, related to H pylori infection. The existence of an independent junctional pathway is questionable, and GEJ adenocarcinomas share features of esophageal and gastric adenocarcinomas. So far it has been impossible to accommodate in a single, coherent classification, all data that are provided by different levels and tools of observation in tumors that develop in the gastroesophageal region. That is why the stratification of pathologic risk factors in such tumors, and their respective precursors, incorporates features from topography, histology, immunohistochemistry, and molecular pathology.