Guo Tian-jiao, Ma Yi-han, Qin Jin-yu, Wang Yi-ping, Yang Jin-lin
Sichuan Da Xue Xue Bao Yi Xue Ban. 2015 Nov;46(6):916-20.
To investigate the clinicopathologic characteristics of superficial adenocarcinoma of esophagogastric junction (AEG), and to analyze the relationship between endoscopic macroscopic type and tumor depth for such cancers.
The clinical data of the 57 superficial AEG patients who underwent endoscopic resection or surgical operation between November 2008 and May 2015 in West China Hospital, Sichuan University were analyzed. Clinicopathologic features were compared between different depth of tumor invasion by univariate and multivariate analysis.
The age ranged between 48 and 76 yr., with an average age of (63.0 +/- 6.8) yr.; 49 cases in male, 8 cases in female. The tumor size ranged between 3.0 and 40.0 mm, the average size was 16. 6 mm. The mucosal carcinoma was 28 cases, the submucosal carcinoma is 29 cases. There were no significant differences in age, gender, histological type and Siewert type in two groups, while there was statistical difference in tumor diameter (P=0.02) and endoscopic typing (P=0.02) between the two groups. The further multivariate analysis revealed that endoscopic macroscopic type (P=0.041) was an independent risk factor of superficial AEG invasion depth. The risk of submucosal invasion was 3.244 times in depressed type as.large as in elevated or flat type of the superficial AEG (95% confidence interval: 1.050-10.023).
The endoscopic macroscopic type may be useful in accurately diagnosing superficial AEG invasion depth. For the endoscopic macroscopic type mainly of depression, especially the type 0-III, which was more likely to infiltrate the submucosal and more likely to have lymph node metastasis, do not recommend to get an endoscopic treatment.
探讨食管胃交界部浅表腺癌(AEG)的临床病理特征,并分析此类癌症内镜下宏观类型与肿瘤深度之间的关系。
分析2008年11月至2015年5月在四川大学华西医院接受内镜切除或手术的57例浅表性AEG患者的临床资料。通过单因素和多因素分析比较不同肿瘤浸润深度的临床病理特征。
年龄范围为48至76岁,平均年龄为(63.0±6.8)岁;男性49例,女性8例。肿瘤大小范围为3.0至40.0mm,平均大小为16.6mm。黏膜癌28例,黏膜下癌29例。两组在年龄、性别、组织学类型和Siewert类型方面无显著差异,而两组在肿瘤直径(P = 0.02)和内镜分型(P = 0.02)方面存在统计学差异。进一步的多因素分析显示,内镜宏观类型(P = 0.041)是浅表性AEG浸润深度的独立危险因素。浅表性AEG凹陷型黏膜下浸润风险是隆起型或平坦型的3.244倍(95%置信区间:1.050 - 10.023)。
内镜宏观类型可能有助于准确诊断浅表性AEG的浸润深度。对于主要为凹陷型的内镜宏观类型,尤其是0-III型,其更易浸润黏膜下层且更易发生淋巴结转移,不建议进行内镜治疗。