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首页> 外文会议>St. Gallen EORTC Gastrointestinal Cancer Conference >Adenocarcinoma of the GEJ: gastric or oesophageal cancer?
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Adenocarcinoma of the GEJ: gastric or oesophageal cancer?

机译：GEJ的腺癌：胃或食管癌？

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According to WHO (2010) adenocarcinomas of the esophagogastric junction (GEJ) are defined as tumors that cross the most proximal extent of the gastric folds regardless of where the bulk of the tumor lies. In addition, these neoplasms are now classified as esophageal cancers by UICC (2010). Recent studies, however, revealed two types of carcinogenesis in the distal oesophagus and at the GEJ, one of intestinal type (about 80 %) and the other of gastric type (about 20 %). These are characterized by marked differences in morphology, tumor stage at diagnosis, and prognosis. Furthermore, both cancer types show different targetable biomarker expression profiles such as Her2 in the intestinal and EGFR in the non-intestinal pathway indicating new therapy options. Due to the fact that carcinomas of the intestinal pathway were typically associated with Barrett's mucosa which was not the case in the non-intestinal-type tumors, this challenges the paradigm "no goblets no Barrett's". Moreover, even the cancer risk of intestinal-type metaplasia has seriously been questioned by a Danish population-based study where Barrett's mucosa turned out to be only a weak indicator of esophageal and GEJ cancer (1 case in 860 patients years). Thus, two biologically different types of cancer arise at the GEJ-esophageal and gastric type that open distinctive targeted treatment options and also question our current concept about the diagnostics of potential precursor lesions as well as the associated screening and surveillance strategy.
机译：根据世界卫生组织（2010）食管胃癌（GEJ）的腺癌（GEJ）被定义为肿瘤，肿瘤越过胃褶皱的最近端程度，无论大部分肿瘤呈现何种肿瘤。此外，这些肿瘤现在被UICC（2010）分类为食管癌。然而，最近的研究显示了远端食道和GEJ中的两种致癌作用，肠道类型（约80％）和其他胃型（约20％）。这些特征在于诊断和预后的形态，肿瘤阶段的显着差异。此外，癌症类型均显示出不同的可靶向生物标志物表达谱，例如在非肠道途径中的肠道和EGFR中的HER2，表明新治疗选择。由于肠道途径的癌癌通常与非肠型肿瘤中不是这种情况的癌症，这挑战了范式“没有哥哥特没有Barrett”。此外，即使是肠型细胞癌的癌症风险也受到丹麦人口的基于丹麦人口的研究，其中巴雷特的粘膜尚未成为食管和Gej癌症的薄弱指标（860名患者1例）。因此，两种生物学上不同类型的癌症在Gej-Neophageal和胃型中出现，即打开独特的靶向治疗方案，并对我们目前的概念有关潜在的前体病变的诊断以及相关的筛查和监测策略。

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