Digestive Diseases and Sciences

, Volume 55, Issue 1, pp 46–53

Characterization of the Gastric Cardia in Volunteers from the General Population

Type of Mucosa, Helicobacter pylori Infection, Inflammation, Mucosal Proliferative Activity, p53 and p21 Expression, and Relations to Gastritis
  • Fredrik Petersson
  • Lennart E. Franzén
  • Kurt Borch
Original Article


The aim of this research was to characterize the mucosa of the gastric cardia in relation to infection with Helicobacter pylori and the occurrence of chronic gastritis in other parts of the stomach in a sample of the general population. In this study, 80 adult volunteers underwent esophagogastroscopy with biopsies from the gastric cardia, corpus, and antrum. Gastritis was classified according to the Sydney system. Chronic gastritis (cardia excepted) was diagnosed in 35 subjects, 30 with Hpylori infection. Epithelial proliferative activity (Ki-67), p53- and p21 expression were examined quantitatively with cell counting after immunohistochemical stainings. Esophagitis was diagnosed macroscopically. Fourty eight subjects had cardia-type and 32 corpus-type mucosa in the anatomical cardia. The prevalence of esophagitis (nine cases) did not differ between these groups. Carditis was more prevalent among subjects with cardia-type mucosa (73 vs. 28%, P < 0.0001). Hpylori was present in 48% of those with cardia-type and 25% of those with corpus-type mucosa (P = 0.06). Of the 44 subjects with carditis, 31 had Hpylori in this location. The group with Hpylori infection had significantly higher mucosal proliferative activity when compared to uninfected subjects. Among the subjects with H. pylori-associated carditis, more p53-positive epithelial cells were detected compared to both the non-infected group (P = 0.0004) and to subjects with non-Hpylori-associated carditis (P = 0.03). In subjects with cardia-type mucosa, and both carditis and gastritis, the degree of chronic inflammation was higher in the cardia compared to the corpus and antrum and the p53 expression was significantly higher in the cardia compared to the corpus, but similar to that in the antrum. The proliferative activity was significantly higher in the antrum compared to the cardia and corpus, respectively. In conclusion, H. pylori infection, carditis, and increased p53 expression are more common in subjects with cardia- than corpus-type mucosa in the gastric cardia. Carditis is mainly related to Hpylori infection. There are some differences regarding inflammation, proliferative activity, and p53 expression between the cardia and other regions of the stomach, yet the significance of these differences remains to be clarified.


Cardia Carditis Gastritis Helicobacter pylori Proliferation Ki-67 p53 p21 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Fredrik Petersson
    • 1
    • 2
  • Lennart E. Franzén
    • 3
  • Kurt Borch
    • 4
  1. 1.Pathology Research DepartmentRyhov HospitalJonkopingSweden
  2. 2.Department of PathologyKarolinska University HospitalStockholmSweden
  3. 3.Department of PathologyMedical Centre HospitalOrebroSweden
  4. 4.Department of SurgeryUniversity Hospital of LinköpingLinkopingSweden

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