Changes of Z-line at gastroesophageal junction in symptom-free subjects from high-incidence area for esophageal cancer in Henan

Z-Line is the boundary at esophageal and gastric cardia junction. Upgrowth of Z-line has been regarded as a manifestation of reflux esophagitis, which may induce Barrett's esophagus in western countries. The present study was undertaken to characterize the appearance changes of Z-line and its correlation with esophageal and gastric cardia precancerous lesions on symptom-free subjects from the high-incidence area for esophageal cancer in Henan. En- doscopy and mucosal biopsy histopathological examination were performed on 1, 217 symptom-free subjects (;?:30 years old) from the high-incidence area for esophageal cancer in Linzhou, Henan. Z-line appearance was recorded as upgrowth, irregular, and indistinct. All the biopsies were fixed with 85 % alcohol and processed for routine HE staining and histopathology. The endoscopic observtion was correlated with histopathological results. The detection rates for the upgrowth (;?:3 cm), irregular and indistinct Z-line were 12%, 10% and 1 %, respectively. The inci- dence for Z-line upgrowth and irregular in male at different age groups was apparently higher than that in female (P < O.05). The incidence for irregular Z-line in young female was higher than in other age groups (P < O.05). With the age increasing, a decreasing tendency for Z-line upgrowth was observed both in male and female. The subjects with Z-line upgrowth had a higher incidence for esophageal basal cell hyperplasia and dysplasia in lower esophageal segment than in those without Z-line upgrowth (PMore