重新审视食管胃结合部癌的特殊性  

Re-examining the specificity of esophagogastric junction cancer

作　　者：胡祥[1] HU Xiang(Department of Gastrointestinal Surgery,the First Affiliated Hospital,Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院胃肠外科,辽宁大连116011

出　　处：《中国实用外科杂志》2024年第10期1102-1108,共7页Chinese Journal of Practical Surgery

摘　　要：食管栅状血管的下端及胃黏膜皱襞的终末端作为食管胃结合部的判断基准,胚胎起源的研究结果提示食管腺及复层扁平上皮的食管与具有单层柱状上皮及腺体组织的胃黏膜结合部,组织学的差异源于胚叶起源,是外胚叶、内胚叶的分界;组织学上在食管胃结合部的固有层深部存在黏液腺的贲门腺。食管胃结合部癌的分型主要有日本的Nishi分型、德国Siewert分型、京都国际共识会议的分类,虽然各分类系统尚未完全统一,但因其发病部位、发病因素以及临床特点,将食管胃结合部癌作为独立的肿瘤类型在世界范围内得到共识。根据食管胃结合部癌的分型制定出合理的胃切除以及淋巴结清扫范围以达到肿瘤学获益和手术安全性的目的。The lower end of the esophageal grating vessel and the terminal end of the gastric folds serve as the criteria for determining the esophagogastric junction.Studies on embryonic origin suggest that the esophagus with esophageal glands under the stratified squamous epithelium and the gastric mucosa with simple columnar epithelium and glandular tissue have histological differences originating from the embryonic origin,which serves as the boundary between endoderm and ectoderm;Histologically,there is a mucinous gland in the deep of lamina propria at the esophagogastric junction,known as the cardia gland.The classification of esophagogastric junction cancer mainly includes the Nishi classification in Japan,the Siewert classification in Germany,and the classification of the Kyoto International Consensus.Although the classification systems are not completely unified,it is widely recognized worldwide that esophagogastric junction cancer is an independent tumor type due to its location of disease,pathogenic factors,and clinical characteristics.Develop a reasonable range of gastric resection and lymph node dissection based on the classification of esophagogastric junction cancer to achieve oncological benefits and surgical safety.

关 键 词：食管胃结合部 腺癌 胚胎 治疗 

分 类 号：R6[医药卫生—外科学]