Two distinct aetiologies of cardia cancer, evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status

Background: Non-cardia gastric adenocarcinoma is positively associated with Helicobacter pylori infection and atrophic gastritis. The role of H pylori infection and atrophic gastritis in cardia cancer is unclear. Aim: To compare cardia versus non-cardia cancer with respect to the premorbid state of the stomach. Methods: Nested case–control study. To each of 129 non-cardia and 44 cardia cancers, three controls were matched. Serum collected a median of 11.9 years before the diagnosis of cancer was tested for anti-H pylori antibodies, pepsinogen I:II and gastrin. Results: Non-cardia cancer was positively associated with H pylori (OR 4.75, 95% CI 2.56 to 8.81) and gastric atrophy (pepsinogen I:II ,2.5; OR 4.47, 95% CI 2.71 to 7.37). The diffuse and intestinal histological subtypes of non-cardia cancer were of similar proportions and both showed a positive association with H pylori and atrophy. Cardia cancer was negatively associated with H pylori (OR 0.27, 95% CI 0.12 to 0.59), but H pylori-positive cardia cancer showed an association with gastric atrophy (OR 3.33, 95% CI 1.06 to 10.5). The predominant histological subtype of cardia cancer was intestinal and was not associated with gastric atrophy compared with the diffuse subtype ((OR 0.72, 95% CI 0.19 to 2.79) vs (OR 3.46, 95% CI 0.32 to 37.5)). Cardia cancer in patients with atrophy had an intestinal: diffuse ratio (1:1) similar to non-cardia cancer (1.9:1), whereas cardia cancers in patients without atrophy were predominantly intestinal (7:1). Conclusion: These findings indicate two aetiologies of cardia cancer, one associated with H pylori atrophic gastritis, resembling non-cardia cancer, and the other associated with non-atrophic gastric mucosa, resembling oesophageal adenocarcinoma. Serological markers of gastric atrophy may provide the key to determining gastric versus oesophageal origin of cardia cancer

Monitoring the flow of Atlantic water through the Faroe-Shetland Channel

This report presents results from an experiment, carried out in 2011-2012 within the EU-THOR project to investigate whether future monitoring of the Atlantic water transport through the Faroe-Shetland Channel might be more efficiently achieved on another section than the traditional Munken-Fair Isle section. The new section is less affected by meso-scale activity and narrower, allowing better horizontal resolution of the mooring array, but the experiment revealed that moving to the new section involved other drawbacks. The experiment also confirmed an earlier conjecture that data from satellite altimetry might provide better estimates of transport variations than estimates based on in situ measurements, solely. Previous efforts to determine the average volume transport of Atlantic water through the channel and its variations have been hampered by lack of information on the thickness variations of the Atlantic layer. Re-evaluating the historical data set, we find that the transport estimates are not significantly affected by assuming that the lower boundary of the Atlantic layer is fixed, equal to the average 5°C-isotherm. Based on the conclusions of this report, we recommend that future in situ monitoring in the channel is re-focused