食管胃结合部腺癌的研究进展

Recent advances in adenocarcinoma of the esophagogastric junction

食管胃结合部腺癌（adenocarcinomaoftheesophagogastricjunction，AEG）作为一类不同于食管癌和胃癌的独立疾病的临床观点，已为多数学者所接受。Siewert分型是目前最科学的方法；胃食管反流、Barrett食管和Hp感染是其发病的重要因素。对于Ⅰ型AEG患者多采用经胸手术，经膈肌裂孔食管切除术路径也显示出一定优势；而Ⅱ、Ⅲ型AEG多采用经腹路径手术并推荐行全胃切除。腔镜手术、内镜黏膜下剥离术（ESD）、新辅助治疗和靶向治疗等治疗方法和理念也在AEG诊治中逐渐发挥着重要作用。

The majority of scholars have agreed that the adenocarcinoma of the esophagogastric junction （AEG）is an independent tumor entity, which is different from squamous cell carcinoma of the e- sophagus and gastric adenocarcinoma. Siewert type is the most scientific method. Gastroesophageal reflux, barrett＇ s esophagus, and the infection of helicobacter pylori are the most important pathogenic factors. For Siewert Ⅰ type ,thoracic approach is applied commonly and transhiatal esophagectomy approach also has some advantages, while Siewert Ⅱ/Ⅲ types usually take abdominal approach and total gastrectomy is rec- ommended. Laparoseopic surgery, endoscopic submucosal resection, neoadjuvant therapy and targeted ther- apy are becoming more and more important in the treatment of AEG.