Incidence of Microscopically Positive Proximal Margins in Adenocarcinoma of the Gastroesophageal Junction
Incidence of Microscopically Positive Proximal Margins in Adenocarcinoma of the Gastroesophageal Junction
复制标题
胃食管连接部腺癌近端切缘镜检阳性的发生率
DOI：
10.1371/journal.pone.0088010
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发表时间：
2014-02-05
期刊：
影响因子：
3.7
通讯作者：
Shen, Lizong
中科院分区：
文献类型：
--
作者：
Gao, Fei;Chen, Jia;Shen, Lizong
目的：调查的发病率和危险因素，显微镜下阳性近端边缘在中国患者腺癌的胃食管junction.Methods：483例患者，谁接受手术治疗的根治性目的的胃食管连接部腺癌在一个单一的高容量的三级医疗中心的病历进行了审查。评价了人口统计学、影像学、内镜、病理学和治疗相关变量。结果：近端切缘阳性率为23.81%。Siewert类型、肿瘤浸润深度、淋巴结受累、血管或淋巴管浸润以及神经周围浸润与近端切缘阳性显著相关。多变量分析，血管或淋巴管浸润和晚期疾病的存在是独立的危险因素，积极近端边缘的患者与腺癌的胃食管junctions.Conclusion：残留癌在近端切除边缘仍然是一个主要的问题，在中国的胃食管连接部腺癌的外科治疗。
Aim: To investigate the incidence and risk factors of microscopically positive proximal margins in Chinese patients with adenocarcinoma of the gastroesophageal junction.Methods: The medical records of 483 patients, who underwent surgical treatment with curative intent for adenocarcinoma of the gastroesophageal junction in a single high-volume tertiary medical center, were reviewed. Demographic, radiographic, endoscopic, pathologic, and treatment-related variables were evaluated. All proximal margins were re-evaluated by two experienced pathologists, and a positive proximal margin was defined as the microscopic presence of invasive tumor cells seen at the esophageal transaction margin submitted en face on final paraffin sections.Results: The incidence of positive proximal margins was 23.81% in this series. Siewert type, depth of tumor invasion, lymph node involvement, presence of vascular or lymphatic invasion, and presence of perineural invasion were significantly associated with positive proximal margins. On multivariate analysis, the presence of vascular or lymphatic invasion and advanced-stage disease were independent risk factors for positive proximal margins in patients with adenocarcinoma of the gastroesophageal junction.Conclusion: Residual cancer at proximal resection margins remains a major issue for the surgical treatment of adenocarcinoma of the gastroesophageal junction in China.