Dolan K, Sutton R, Walker S J, Morris A I, Campbell F, Williams E M
Department of Surgery, Royal Liverpool University Hospital, UK.
Br J Cancer. 1999 May;80(5-6):834-42. doi: 10.1038/sj.bjc.6690429.
The current ICD-O classification of carcinomas of the oesophagus and stomach causes epidemiological and clinical confusion. This study compares the epidemiological and clinical features of each subtype and subsite of adenocarcinomas of the oesophagus and stomach, to assess requirements for a new classification of these carcinomas. Data were extracted with appropriate validity checks on all cases of oesophageal and gastric carcinomas identified throughout the period 1974-1993 by the Merseyside and Cheshire Cancer Registry, which covers a population of 2.5 million. The incidence of adenocarcinomas of the lower oesophagus and cardia trebled in males, and doubled in females, whereas adenocarcinoma of the subcardia region of the stomach declined in both sexes. Adenocarcinomas of the lower oesophagus and of the cardia were similar for median age at diagnosis, male to female ratio, percentage of patients who smoked and survival; both were significantly different from carcinomas of the subcardia in these respects. These data imply that adenocarcinomas of the lower oesophagus and cardia are the same disease. A new subsite classification of oesophageal and gastric carcinomas is proposed that includes the gastro-oesophageal junction as a distinct subsite, to facilitate surveillance, management and research.
当前国际疾病分类肿瘤学（ICD - O）中对食管癌和胃癌的分类造成了流行病学及临床方面的混乱。本研究比较了食管和胃腺癌各亚型及亚部位的流行病学和临床特征，以评估对这些癌症进行新分类的必要性。通过对默西塞德郡和柴郡癌症登记处1974 - 1993年期间确诊的所有食管癌和胃癌病例进行适当的有效性检查后提取数据，该登记处覆盖人口达250万。男性下食管和贲门腺癌的发病率增长了两倍，女性增长了一倍，而胃贲门下部区域的腺癌在两性中发病率均下降。下食管腺癌和贲门腺癌在诊断时的中位年龄、男女比例、吸烟患者百分比及生存率方面相似；在这些方面，二者均与贲门下部癌显著不同。这些数据表明下食管腺癌和贲门腺癌是同一种疾病。提议对食管癌和胃癌进行新的亚部位分类，将胃食管交界作为一个独特的亚部位，以促进监测、管理和研究。
