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The purpose of research was the study of the structural variants of distal esophageal mucosa and gastric
cardiac mucosa using autopsy samples. We studied 1127 early autopsies collected within 6-8 hours after
death in order to minimize autolysis from persons who died from cardiovascular diseases in hospitals (mean
age 61,3±7,2 years). Patients with a history of gastroesophageal reflux (GER) and other diseases of the
digestive system were excluded from the study. The mucosa of the 4 walls of esophagus and stomach was
examined within 10 cm above and below the esophageal-gastric junction (EGJ) using stepped histological
sections. Colocalization of Z-line and EGJ (plus minus 1 cm due to irregular Z-line) was revealed in 315
cases (28%), Z-line was higher than EGJ, at height varying from some millimeters up to 6 cm in 806 cases
(71, 5%) and Z-line was below EGJ by 2 cm in gastric cardia in 6 cases (0, 5%), all histologically diagnosed
as chronic atrophic pan-gastritis. The mucosa of cardiac type (MCT) was absent in 14 cases (1,2%), in 6 of
these it at Z-line in gastric cardia and in 8 cases, at the level of EGJ plus minus 1 cm. MCT was revealed
in 1113 cases (98,8%), from these its upper level was at height varying from some millimeters up to 6 cm
above EGJ in 806 cases (71,5%), at the level of EGJ plus minus 1 cm in 307 cases (27,3%), and the lower
bound of all cases in 1113 was below EGJ plus minus 1 cm in the gastric cardia for up to 1.5 cm. The frequency of MCT detection and its length significantly (p <0.05) increased with age, prevailing after 60 years
in men, but not in women, in whom the frequency of SOCT, exceeding 1 cm in the area of PH, was 3.1 times
lower.prevailing after 60 years in men, but not in women, in whom the frequency of MCT, exceeding 1 cm
in the area of EGJ, was 3,1 times lower. Foci of intestinal metaplasia were found within esophageal MCT
in 48 observations (4.3%) and in 11 (1%), in the region of EGJ and gastric cardia against the background
of MCT or atrophic altered fundus mucosa (MFT). It was concluded that MCT in EGJ (plus minus 1 cm
due to irregular Z-line) should be regarded as normal, wherein the most part of gastric cardia is lined with
MFT. Lack of MCT and the shift of the Z-line in gastric cardia apparently are the abnormalities due to the
effect of hypo-acid state (in atrophic gastritis). Localization of MCT proximal to 1 cm from PHL is a common
pathological process, the frequency of which increases with age developing in response to GER. The
intestinal metaplasia of esophagus, EGJ and gastric cardia are certainly pathological processes, but different
in their essence and prognosis.
Key words: distal esophageal mucosa, gastric cardiac mucosa, structural variants, autopsy
DOI: 10.31088/2226-5988-2018-28-4-4-12
УДК: 616.091