Abstract
This article gives the rationale for the likelihood that the precursor lesion for cancer of the cardia is either short segments of Barrett's esophagus or even intestinalized (globlet cell change) mucosa at a normally located squamo-columnar junction. Intestinal metaplasia of the cardia is likely a wear and tear phenomenon in many individuals without gastroesophageal reflux disease (GERD). Markers that stratify risk further are required before routine biopsy specimens of the Z-line can be obtained in the clinical evaluation of patients with GERD.
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