中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (04): 267-270.

• 专题笔谈 • 上一篇    下一篇

食管胃结合部腺癌流行趋势、病因及防治

陈志峰   

  1. 河北医科大学第四医院肿瘤研究所,河北石家庄050011
  • 出版日期:2012-04-01 发布日期:2012-03-31

  • Online:2012-04-01 Published:2012-03-31

摘要:

国内食管癌高发区人群流行病学分析发现:食管鳞癌发病率下降;食管胃结合部腺癌(AEG)发病率显著上升。欧美学者认为,肥胖和胃食管反流性疾病是这两类肿瘤的独立危险因素。我国食管癌高发区的遗传度为(29.67±4.32)%,分离比0.181,95%CI:0.15~0.21,属于多基因遗传病。根据AEG的病理演变机理和WHO的临床处理原则,目前食管癌高发区对贲门重度不典型增生者主要采用内镜下切除;而重视萎缩性或活动性胃炎的干预治疗,对降低肠化,减少AEG的发病也可能是比较现实的措施之一。

关键词: 食管胃结合部腺癌, 流行病学

Abstract:

Adenocarcinoma of the esophagogastric junction: epidemic trends, causes, prevention and therapy      CHEN Zhi-feng. Cancer Institute, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Abstract    Population epidemiology analysis of esophageal cancer for the high risk region in China finds that: incidence of esophageal squamous cell carcinoma has decreased and that of adenocarcinoma of the esophagogastric junction(AEG) has increased significantly. European and American scholars believe that obesity and stomach-esophageal reflux disease are independent risk factors of the two types of cancer. In the high risk region of esophageal cancer in China, the heritability is (29.67±4.32)% and the segregation ratio is 0.181, 95% CI (0.15~0.21). Esophageal cancer belongs to multi-gene genetic disease. According to the evolution of the pathological mechanism of gastric cardia  adenocarcinoma and the WHO's clinical treatment principles, cardiac severe atypical hyperplasia were mainly endoscopic resection in the high risk region in China. Paying attention to the intervention of atrophic gastritis or active gastritis may be the realistic measures to reduce intestinal metaplasia and the incidence of AEG.

Key words: adenocarcinoma of the esophagogastric junction, epidemiology