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食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)作为一类不同于食管癌和胃癌的独立疾病的临床观点,已为多数学者所接受。Siewert分型是目前最科学的方法;胃食管反流、Barrett食管和Hp感染是其发病的重要因素。对于Ⅰ型AEG患者多采用经胸手术,经膈肌裂孔食管切除术路径也显示出一定优势;而Ⅱ、Ⅲ型AEG多采用经腹路径手术并推荐行全胃切除。腔镜手术、内镜黏膜下剥离术(ESD)、新辅助治疗和靶向治疗等治疗方法和理念也在AEG诊治中逐渐发挥着重要作用。
The clinical view of adenocarcinoma of the esophagogastric junction (AEG) as a kind of independent disease different from esophageal and gastric cancer has been accepted by most scholars. Siewert classification is the most scientific method; gastroesophageal reflux, Barrett’s esophagus and Hp infection is an important factor in the pathogenesis. For type Ⅰ AEG patients with transthoracic surgery, the path of diaphragmatic hiatus esophageal resection also showed some advantages; and Ⅱ, Ⅲ AEG more use of abdominal surgery and recommended total gastrectomy. Endoscopic surgery, endoscopic submucosal dissection (ESD), neoadjuvant therapy and targeted therapies and other treatment methods and concepts in the diagnosis and treatment of AEG also gradually play an important role.