Background: Chronic inflammation and intestinal metaplasia lead to gastric and esophageal adenocarcinoma. Past research has provided controversial findings about the etiology of inflammation and intestinal metaplasia in the cardia and the Z-line.

Objectives: The aim of this study was to evaluate clinicopathological findings of the cardia and gastroesophageal junction in adult candidates for endoscopy in Qazvin, Iran.

Methods: Biopsy was performed for 124 ambulatory adult patients without any evidence of cancer. Specimens were obtained from the antrum and the cardia of the stomach, the Z-line, and 2 cm above the Z-line. A comparison was made between the histological, clinical and endoscopic data obtained from the patients.

Results: Helicobacter pylori were significantly related to active inflammation in the antrum and the cardia, but not in the Z-line. Another finding was that active carditis was related to active antritis and active Z-line inflammation. A further observation was the positive correlation between cardiac and Z-line metaplasia. Finally, a relationship was observed between the type of cardiac mucosa and the presence of metaplasia in the cardia and the Z-line.

Conclusions: The study revealed that inflammation in the cardia and, to a lesser extent, the Z-line is related to H. pylori and antral gastritis and that the metaplasia of these areas is related to gastroesophageal reflux disease. Lastly, both H. pylori and gastroesophageal reflux disease are important in the pathology of these areas.