138例食管胃结合部肿瘤病例分析

目的：通过分析138例食管胃结合部肿瘤的临床病理特征、手术方式,探讨食管胃结合部肿瘤不同Siewert分型和手术方式对预后的影响。方法：回顾性分析洛阳市中心医院2000年-2006年食管胃结合部肿瘤138例手术病例的临床病理特征及手术方式,将138例病例参照Siewert分类方法进行分类,分析不同Siewert分型和手术方式对预后的影响。结果：138例中AEGⅠ型10例,AEGⅡ型20例,AEGⅢ型108例,三种类型AEG预后存在明显差别,不同手术方式的5年生存率明显不同,脾切除的患者生存时间无明显改善,并发症增加。结论：三种类型的AEG预后不同,选择不同手术方式其5年生存率亦不同,根据AEG分型选择适当手术方式可以改善预后;脾脏切除并不能改善患者预后,保留脾脏的淋巴结清扫是可行的,但要确保做到肿瘤的根治切除和严格的淋巴结清扫。

Clinical Analysis of 138 Cases of Adenocarcinoma of the Esophagogastric Junction

Objective：To study and research into the clinicopathological characteristics and surgical modes of 138 cases of adenocarcinoma of the esophagogastric junction retrospective,to discuss different siewert classification and surgical modes influence on prognosis.Method：The data of 138 cases of patients with adenocarcinoma of the esophagogastric junction at Luoyang central hospital from 2000 to 2006 were reviewed.Surgical patients were defined and classified according to siewert’s classification,and 138 patients were up to the classification.Then the study compared and analyzed the clinicopathological characteristics and the survival rates of the three types of the tumor.Result：Among the 138 patients,there were 10 patients with adenocarcinoma of the distal esophagus（Type Ⅰ）;20 patients with true carcinoma of cardia（Type Ⅱ）;and 108 patients with subcortical carcinoma（Type Ⅲ）.Obvious different prognosis were found in the clinicopathological characteristics of the three types,significant difference of the 5-year survival rates was found among the different surgery options,splenectomy cannot prolong patients’life but produce many complications.Conclusion：The prognosis of the three types of tumor was different;patients who had undergone different surgical modes were found to have different 5-year survival rates;according to the AEG classification choose proper operation method can improve the prognosis;splenectomy cannot prolong patients’life,lymphadenectomy with Preserving spleen was feasible under a complete tumor removal with adequate lymphadenectomy.