Bornschein Jan, Quante Michael, Jansen Marnix
Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, United Kingdom and NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.
Klinik für Innere Medizin II, Universitätsklinikum Freiburg, Germany.
Best Pract Res Clin Gastroenterol. 2021 Mar-Apr;50-51:101729. doi: 10.1016/j.bpg.2021.101729. Epub 2021 Feb 14.
Chronic acid-biliary reflux and Helicobacter pylori infection are instrumental environmental drivers of cancer initiation and progression in the upper gastrointestinal tract. Remarkably, although these environmental carcinogens are quite dissimilar, the tumour progression cascade these carcinogens engender is highly comparable. For this reason, studies of malignant progression occurring at the anatomic borderland between the oesophagus and the stomach have traditionally lumped junctional adenocarcinomas with either oesophageal adenocarcinoma or gastric adenocarcinoma. Whilst studies have revealed remarkable epidemiological and genetic similarities of these cancers and their associated premalignant conditions, these works have also revealed some key differences. This highlights that further scientific effort demands a dedicated focus on the understanding of the cell-cell interaction between the epithelium and the local microenvironment in this anatomic region. We here review available evidence with regards to tumour progression occurring at the gastro-oesophageal junction and contrast it with available data on cancer evolution in the metaplastic oesophagus and distal stomach.
慢性胆汁酸反流和幽门螺杆菌感染是上消化道癌症发生和进展的重要环境驱动因素。值得注意的是，尽管这些环境致癌物差异很大，但它们引发的肿瘤进展级联却高度相似。因此，传统上对食管和胃之间解剖交界部位发生的恶性进展的研究，将交界腺癌与食管腺癌或胃腺癌归为一类。虽然研究已经揭示了这些癌症及其相关癌前病变在流行病学和遗传学上的显著相似性，但这些研究也发现了一些关键差异。这突出表明，进一步的科学研究需要专门关注对该解剖区域上皮细胞与局部微环境之间细胞间相互作用的理解。我们在此回顾关于胃食管交界部位肿瘤进展的现有证据，并将其与化生食管和远端胃中癌症演变的现有数据进行对比。
