食管胃结合部癌前病变和早期癌的研究进展

Siewert将在食管胃连接部上下5 cm范围内发生的肿瘤定义为食管胃结合部肿瘤,包括远端食管腺癌、真正意义上的贲门癌和近端胃癌。传统上认为远端食管腺癌起源于Barrett食管黏膜,与反流相关疾病关系密切;贲门腺癌起源于贲门黏膜,与幽门螺杆菌感染关系密切;而近端胃癌则与幽门螺杆菌和肠化具有较强的关联性。反流相关疾病、Barrett食管和肠上皮化生、幽门螺杆菌感染等与食管胃结合部肿瘤的关系一直是该部位肿瘤的研究热点,但是也存在强烈的争议。随着食管胃结合部解剖学和组织学发展成熟,结合早期发现该部位癌变倾向,使得关于食管胃结合部癌变的病因、分子机制、解剖学及组织学上的探讨越来越深入明朗。因此在早期发现该部位病变并加以干预可以有效地帮助临床和科研工作者解决困扰,同时显著提高肿瘤患者的生存率。

The study and research of gastro-esophageal junction early lesion and adenocarcinoma

Siewert defined esophagogastric junction tumors as tumor esophagogastric junction within the range of the upper and lower 5 cm, and divided it into distal esophageal adenocarcinoma, gastric cardia in the true sense and proximal gastric adenocarcinoma. Traditionally considered distal esophageal adenocarcinoma in Barrett＆#39;s esophagus mucosa origin, closely related with reflux diseases;cardia adenocarcinoma originated in the cardia mucosa, closely related to Helicobacter pylori infection;proximal gastric adenocarcinoma strongly correlation with intestinal metaplasia and Helicobacter pylori. The relationship between reflux-related disease, Barrett esophagus, intestinal metaplasia, Helicobacter pylori infection and gastroesophageal junction tumors has been the site of the tumor hotspot, and has a strong controversy. With the esophagogastric junction anatomy and histology developed, combined with early detection, makes the etiology, molecular mechanisms, anatomy and histology about gastroesophageal junction cancer more deeply clear. Therefore, early detection of the lesion and to intervene effectively can help clinicians and researchers to solve problems, while significantly improv the survival rate of cancer patients.