中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
1期
136-140
,共5页
食管胃接合处%癌前病变%早期癌%监测%治疗
食管胃接閤處%癌前病變%早期癌%鑑測%治療
식관위접합처%암전병변%조기암%감측%치료
Esophagogastric junction%Early lesion%Early stage of adenocarcinoma%Surveillance%Therapy
Siewert将在食管胃连接部上下5 cm范围内发生的肿瘤定义为食管胃结合部肿瘤，包括远端食管腺癌、真正意义上的贲门癌和近端胃癌。传统上认为远端食管腺癌起源于Barrett食管黏膜，与反流相关疾病关系密切；贲门腺癌起源于贲门黏膜，与幽门螺杆菌感染关系密切；而近端胃癌则与幽门螺杆菌和肠化具有较强的关联性。反流相关疾病、Barrett 食管和肠上皮化生、幽门螺杆菌感染等与食管胃结合部肿瘤的关系一直是该部位肿瘤的研究热点，但是也存在强烈的争议。随着食管胃结合部解剖学和组织学发展成熟，结合早期发现该部位癌变倾向，使得关于食管胃结合部癌变的病因、分子机制、解剖学及组织学上的探讨越来越深入明朗。因此在早期发现该部位病变并加以干预可以有效地帮助临床和科研工作者解决困扰，同时显著提高肿瘤患者的生存率。
Siewert將在食管胃連接部上下5 cm範圍內髮生的腫瘤定義為食管胃結閤部腫瘤，包括遠耑食管腺癌、真正意義上的賁門癌和近耑胃癌。傳統上認為遠耑食管腺癌起源于Barrett食管黏膜，與反流相關疾病關繫密切；賁門腺癌起源于賁門黏膜，與幽門螺桿菌感染關繫密切；而近耑胃癌則與幽門螺桿菌和腸化具有較彊的關聯性。反流相關疾病、Barrett 食管和腸上皮化生、幽門螺桿菌感染等與食管胃結閤部腫瘤的關繫一直是該部位腫瘤的研究熱點，但是也存在彊烈的爭議。隨著食管胃結閤部解剖學和組織學髮展成熟，結閤早期髮現該部位癌變傾嚮，使得關于食管胃結閤部癌變的病因、分子機製、解剖學及組織學上的探討越來越深入明朗。因此在早期髮現該部位病變併加以榦預可以有效地幫助臨床和科研工作者解決睏擾，同時顯著提高腫瘤患者的生存率。
Siewert장재식관위련접부상하5 cm범위내발생적종류정의위식관위결합부종류，포괄원단식관선암、진정의의상적분문암화근단위암。전통상인위원단식관선암기원우Barrett식관점막，여반류상관질병관계밀절；분문선암기원우분문점막，여유문라간균감염관계밀절；이근단위암칙여유문라간균화장화구유교강적관련성。반류상관질병、Barrett 식관화장상피화생、유문라간균감염등여식관위결합부종류적관계일직시해부위종류적연구열점，단시야존재강렬적쟁의。수착식관위결합부해부학화조직학발전성숙，결합조기발현해부위암변경향，사득관우식관위결합부암변적병인、분자궤제、해부학급조직학상적탐토월래월심입명랑。인차재조기발현해부위병변병가이간예가이유효지방조림상화과연공작자해결곤우，동시현저제고종류환자적생존솔。
Siewert defined esophagogastric junction tumors as tumor esophagogastric junction within the range of the upper and lower 5 cm, and divided it into distal esophageal adenocarcinoma, gastric cardia in the true sense and proximal gastric adenocarcinoma. Traditionally considered distal esophageal adenocarcinoma in Barrett's esophagus mucosa origin, closely related with reflux diseases;cardia adenocarcinoma originated in the cardia mucosa, closely related to Helicobacter pylori infection;proximal gastric adenocarcinoma strongly correlation with intestinal metaplasia and Helicobacter pylori. The relationship between reflux-related disease, Barrett esophagus, intestinal metaplasia, Helicobacter pylori infection and gastroesophageal junction tumors has been the site of the tumor hotspot, and has a strong controversy. With the esophagogastric junction anatomy and histology developed, combined with early detection, makes the etiology, molecular mechanisms, anatomy and histology about gastroesophageal junction cancer more deeply clear. Therefore, early detection of the lesion and to intervene effectively can help clinicians and researchers to solve problems, while significantly improv the survival rate of cancer patients.
