食管胃结合部腺癌临床病理特征及术后辅助放化疗研究现状

近年来食管胃结合部腺癌(AEG)的发病率急剧上升,其解剖学部位特殊,且转移复发规律复杂。越来越多的学者认为其是一类不同于食管癌和胃癌的独立的疾病。由于多数患者确诊时已处于局部进展期,单纯手术治疗局部复发率高,生存状况较差,术后辅助治疗有其非常重要的临床价值。目前无专门针对于食管胃结合部腺癌术后辅助治疗价值的研究数据,多数包括在食管癌或胃癌进行研究,也未将食管胃结合部腺癌的病例进行亚组分析,术后辅助治疗的获益人群及放疗靶区勾画范围等还存在争议。放疗勾画靶区时应根据食管胃结合部腺癌临床病理特征、不同Siewert分型和淋巴结转移规律以及术后复发转移特点进行综合考虑。

Clinical and pathological features of esophageal and gastric junction adenocarcinoma and current status of postoperative adjuvant chemoradiotherapy

The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rising rapidly in recent years. AEG as an independent disease different from squamous cell carcinoma of the esophagus and gastric adenocarcinoma is getting acknowledged for most of scholars, with the distinctive anatomy location and involute recurrence and metastasis style. A higher rate of relapse and poor prognosis after resection become conscious since most of patients have been diagnosed with advanced disease, and adjuvant chemoradiotherapy needs to be valued further. But so far, there is no clinical data and subgroup analysis aimed at the value of postoperative treatment for AEG specially, leading to controversy is remaining in patients could get benefit from postoperative treatment, and delineation of the radiation target, etc. The design of the irradiation target should in terms of the clinical-pathological characteristics of the AEG, Siewert’s subtypes, the lymph node metastasis mapping and recurrence characteristics after surgery.