基于Siewert分型食管胃结合部腺癌的治疗策略

Treatment strategies for adenocarcinoma of esophagogastric junction based on Siewert classification

  • 摘要:  近年来,胃癌发病率在全世界范围逐年下降,但食管胃结合部腺癌(AEG)发病率却呈明显上升趋势,以欧洲、美洲国家尤为明显。AEG预后较差,建立AEG最佳诊断与治疗策略,从而改善患者的远期疗效极其必要。目前,最常用的AEG分型是1987年由德国学者基于食管胃结合部的解剖学特点提出的Siewert分型,其为手术方式的选择提供了重要指导意义。与欧洲、美洲国家比较,亚洲国家AEG以Siewert Ⅱ型或Ⅲ型多见,且主要依照近端胃癌方案治疗。与其他部位胃肿瘤比较,AEG在解剖、生理、病理等方面存在明显差异性和特殊性,且在外科治疗和综合治疗问题上还存在较大争议。

     

    Abstract:  In recent years, the incidence of gastric cancer has been decreasing year by year in the world, but the incidence of adenocarcinoma of esophagogastric junction (AEG) has shown a significant upward trend, especially in western countries such as Europe and America. The prognosis of AEG is poor, therefore, it is extremely necessary to establish AEG′s best diagnosis and treatment strategies to improve the long-term outcome of AEG. Nowadays, the most commonly used AEG classification is the Siewert classification proposed by German scholars in 1987, which is based on the anatomical features of the esophagogastric junction. It provides guidance for the choice of surgical methods. Compared with European and American countries, Siewert type Ⅱ or type Ⅲ are more common in Asian countries, and are mainly treated as the proximal gastric cancer. Compared with gastric tumors in other areas, AEG has obvious differences and specialities in anatomy, physiology and pathology, and there is still much controversy in the field of surgical and comprehensive treatment.

     

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