食管胃交界腺癌Siewert分型的临床病理研究

Siewert classification for adenocarcinoma of the esophagogastric junction

目的:探讨食管胃交界腺癌Siewert分型的临床病理特征。方法:对216例食管胃交界腺癌病人的临床、病理及预后随访进行研究,利用Siewert分型方法进行分型。结果:按照Siewert分型,此组病例食管远端腺癌7例(Ⅰ型),真性贲门癌134例(Ⅱ型),贲门下胃癌75例(Ⅲ型)。分型病例以Ⅱ型(62.1%)多见,而Ⅰ型(3.2%)少见;三型病变5年生存率分别为71.4%、65.7%和60.0%;三型患者在年龄、性别方面无明显差异,均多见于60岁左右老年人,以男性多见。Ⅱ、Ⅲ型晚期病人明显增多;三型病人组织学分型均以管状腺癌最常见,病理学分级Ⅰ级少见,Ⅱ和Ⅲ级常见;三型肿瘤淋巴结转移率基本相当。结论:食管胃交界腺癌按照Siewert分型分为三型,以Ⅱ和Ⅲ型多见,Ⅰ型少见,Ⅱ型和Ⅲ型病人基本情况相似,与Ⅰ型间存在差异。

Objective：To explore the clinicopathologic features,Siewert classification of adenocarcinoma of the esophagogastric junction.Methods：The clinical recards of 216 cases of adenocarcinoma of the esophagogastric junction（AEJ）were reviewed.Clinicopathologic and survival characteristics were analyzed according to Siewert＇s standards.Results：According to Siewert classification,7 had adenocarcinoma of the distal esophagus（Type Ⅰ）,134 had true carcinoma of cardia（TypeⅡ）,and 75 had subcardial carcinoma（TypeⅢ）.The third type lesions 5-year survival rate was 71.4%,65.7% and 60.0% respectively,TypeⅢ patients,without obvious differences for age and sex,were more in elderly 60-year-old,with more than men.Advanced stage patients increased obviously in typeⅡand type Ⅲ patients.The 3 type of patients with organizational credit tubular adenocarcinoma.Pathology grade,grade Ⅱand Ⅲwere to see frequently.Three basic type of tumor lymph node metastasis rate was to equal.Conclusion：According to Siewert＇s classification,AEG is classified into type Ⅰ,type Ⅱ and type Ⅲ.Between type Ⅰ and type Ⅱ,differences are dominating,while between type Ⅱ and type Ⅲ tumors,similarities are more prominent.Further study is still necessary to clear the relations between them thoroughly.