食管胃交界腺癌的病理特征及预后分析

目的探讨食管胃交界腺癌的病理特征及预后影响因素。方法对216例食管胃交界腺癌患者的病理资料及预后影响因素作回顾性分析。结果 216例肿瘤的大体类型为溃疡型168例、蕈伞型25例、弥漫浸润型8例、局部黏膜糜烂型15例,病理学分级Ⅰ级30例、Ⅱ级101例、Ⅲ级85例,S iewert分型Ⅰ型7例、Ⅱ型134例、Ⅲ型75例。术后5 a生存率为59.3%,Cox模型多因素分析结果显示,肿瘤临床分期、组织学分级对食管胃交界腺癌预后有显著影响（P均〈0.05）。结论食管胃交界腺癌以溃疡型、Ⅱ型常见,预后较差,肿瘤临床分期、组织学分级可以作为独立预后判断指标。

Analysis of pathological characteristics and prognosis of adenocarcinoma of esophagogastric junction

Objective To explore the pathologic features and prognostic factors of adenocarcinoma of the esophagogastric junction.Methods The clinical records and prognostic factor of 216 cases with adenocarcinoma of the esophagogastric junction were analyzed.Results In 216 cases,there were ulceratine type 168 cases,polypoid type 25 cases,infiltrating type 8 cases,and superfical depressed type 15 cases.Including pathological grade Ⅰ30 cases,gradeⅡ101 cases,grade Ⅲ 85 cases.According to Siewert classification,Ⅰtype 7 cases,Ⅱtype 134 cases,Ⅲ type 75 cases.The 5-year survival rates was 59.3%.On multivariate analysis,following variables had significant effect on prognosis： the clinical stage,the degrees of differentiation（P〈0.05）.Conlusions The common types of adenocarcinoma of the esophagogastric junction are ulcerative type and SiewertⅡ type.The prognosis of adenocarcinoma of the esophagogastric junction is poor,the clinical stage and the degrees of differentiation are the independent prognosis indicator.