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Adenocarcinoma of the esophagogastric junction and its background mucosal pathology: A comparative analysis according to Siewert classification in a Japanese cohort.
Cancer Medicine ( IF 2.9 ) Pub Date : 2018-09-21 , DOI: 10.1002/cam4.1763 Masayuki Urabe 1, 2 , Tetsuo Ushiku 2 , Aya Shinozaki-Ushiku 2 , Akiko Iwasaki 2 , Sho Yamazawa 2 , Hiroharu Yamashita 1 , Yasuyuki Seto 1 , Masashi Fukayama 2
Cancer Medicine ( IF 2.9 ) Pub Date : 2018-09-21 , DOI: 10.1002/cam4.1763 Masayuki Urabe 1, 2 , Tetsuo Ushiku 2 , Aya Shinozaki-Ushiku 2 , Akiko Iwasaki 2 , Sho Yamazawa 2 , Hiroharu Yamashita 1 , Yasuyuki Seto 1 , Masashi Fukayama 2
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Adenocarcinoma of the esophagogastric junction (AEG) has heterogeneous carcinogenic process due to its location straddling the esophagogastric junction. We assessed background mucosal pathology and its correlation with clinicopathological features of each Siewert type of AEG. Clinicopathological and immunohistochemical analyses of 103 AEGs and 58 gastric cancers (GCs) were conducted. Background mucosal features were evaluated according to the updated Sydney System. Siewert classification divided 103 AEGs into three type I, 75 type II, and 25 type III tumors, respectively. Two type I, 9 type II AEGs, and none of type III AEGs were Barrett-related and were excluded from further analysis. Background mucosa of type III AEGs more frequently showed moderate to marked degree of atrophy and intestinal metaplasia than those of type II AEGs and was very similar to those of GCs. Among type II AEGs, tumors with atrophic background were significantly associated with higher patient age and intestinal-type histology. Type II AEGs with nonatrophic background, but not those with atrophic background, showed more frequent mismatch repair deficiency, TP53 overexpression, and less frequent intestinal phenotypic markers expression than type III AEG or GC. Type II AEGs with atrophic background involved suprapancreatic nodes more frequently than those without. We demonstrated that chronic atrophic gastritis was a major precancerous condition of AEG in the Japanese population, especially Siewert type III which had background mucosal pathology similar to that of GC. Type II AEGs with and without atrophic background showed some clinicopathological differences, and these observations might represent heterogeneous carcinogenic process within type II AEGs.
中文翻译：
食管胃交界处的腺癌及其背景黏膜病理学：根据日本人群中Siewert分类的比较分析。
食管胃交界处的腺癌（AEG）由于其位置跨越食管胃交界处而具有不同的致癌过程。我们评估了背景黏膜病理及其与每种Siewert类型的AEG的临床病理特征的相关性。对103例AEG和58例胃癌（GC）进行了临床病理和免疫组化分析。根据更新的悉尼系统对背景粘膜特征进行了评估。Siewert分类法将103种AEG分别分为I型，75型，III型和25型三个肿瘤。两种I型，9型II型AEG和III型AEG中没有一种与Barrett相关，因此被排除在进一步分析之外。与II型AEG相比，III型AEG的背景粘膜更频繁地显示出中度至明显的萎缩和肠化生程度，并且与GC极为相似。在II型AEG中，具有萎缩背景的肿瘤与较高的患者年龄和肠道类型的组织学密切相关。与III型AEG或GC相比，具有非萎缩背景的II型AEG（而非萎缩背景的II型AEG）显示出更频繁的错配修复缺陷，TP53过表达和肠道表型标记物表达。具有萎缩背景的II型AEG比没有胰腺萎缩的更为频繁。我们证明了慢性萎缩性胃炎是日本人群AEG的主要癌前病变，尤其是Siewert III型，其背景黏膜病理学与GC相似。具有和没有萎缩背景的II型AEG表现出一些临床病理学差异，这些观察结果可能代表II型AEG内的异质致癌过程。
更新日期：2018-09-21
中文翻译：
食管胃交界处的腺癌及其背景黏膜病理学：根据日本人群中Siewert分类的比较分析。
食管胃交界处的腺癌（AEG）由于其位置跨越食管胃交界处而具有不同的致癌过程。我们评估了背景黏膜病理及其与每种Siewert类型的AEG的临床病理特征的相关性。对103例AEG和58例胃癌（GC）进行了临床病理和免疫组化分析。根据更新的悉尼系统对背景粘膜特征进行了评估。Siewert分类法将103种AEG分别分为I型，75型，III型和25型三个肿瘤。两种I型，9型II型AEG和III型AEG中没有一种与Barrett相关，因此被排除在进一步分析之外。与II型AEG相比，III型AEG的背景粘膜更频繁地显示出中度至明显的萎缩和肠化生程度，并且与GC极为相似。在II型AEG中，具有萎缩背景的肿瘤与较高的患者年龄和肠道类型的组织学密切相关。与III型AEG或GC相比，具有非萎缩背景的II型AEG（而非萎缩背景的II型AEG）显示出更频繁的错配修复缺陷，TP53过表达和肠道表型标记物表达。具有萎缩背景的II型AEG比没有胰腺萎缩的更为频繁。我们证明了慢性萎缩性胃炎是日本人群AEG的主要癌前病变，尤其是Siewert III型，其背景黏膜病理学与GC相似。具有和没有萎缩背景的II型AEG表现出一些临床病理学差异，这些观察结果可能代表II型AEG内的异质致癌过程。
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