Cardia cancer

Cardia cancer outlined in China's high incidence of esophageal cancer incidence rate is also high, according to these regions and the governing body tumor research statistics, cardia cancer and esophageal cancer is in the ratio of 2 : 1. The correct definition of cardiac cancer occurs in the gastric cardia, which is esophagogastric junction line about 2 cm within the scope of adenocarcinoma. It is a special type of gastric cancer, and cancer of the esophagus under distinction. But it and other parts of gastric cancer, with its own anatomical and histological characteristics of clinical manifestations, unique to the diagnosis and treatment of the poor and surgical treatment. Cause pathogenesis a) a general classification. Advanced Gastrointestinal type generally follow Borrman type, The basic classification of mushroom, the ulcer type I, type II and ulcer infiltrating. My author thus divided into four right-cardia cancer. ① uplift type : tumor for a clear edge over the cavity to uplift the masses, with the cauliflower, nodules or polyps giant block-like, have shallow ulcers; ② limitations ulcer type : tumor deep ulcers, organizations such as the edge of dike - like, plane with the normal realm of clarity. ③ infiltration ulcer type : ulcer risk was not clear, the plane and surrounding tissue boundaries blurred; ④ infiltrating : tumor infiltration within the cardiac wall growth, involvement Department uniform thickness and surrounding tissue without boundaries, Sticking around mucosa often contraction. Large type and histological types, ①, ② to score two type of mucinous carcinoma and adenocarcinoma more. Infiltration ulcer type poorly differentiated adenocarcinoma and adenocarcinoma of the increased proportion. Infiltrating were mostly undifferentiated diffuse type of mucinous carcinoma or adenocarcinoma. Surgical treatment prognosis to uplift the best-constrained ulcer-second, less-invasive ulcer, infiltration of the worst type. Cardia adenocarcinoma histology there are two main types : adenocarcinoma with clear mucus secretion of mucus adenocarcinoma. According to this second category differentiation divided into well differentiated, and undifferentiated diffuse three subtypes. Differentiation capital is close to prognosis with surgery. Apart from mucinous carcinoma and adenocarcinoma, a rare cardiac cancer some of the histological types, such as prostate carcinoma, undifferentiated carcinoma, carcinoid (Argyrophil cell carcinoma), and sarcoma, such as cancer. 2. Early cardiac cancer early general morphology and other parts of stomach and esophageal cancer in the early similarity. Can be simply divided into three types, Depression-① : carcinoid tumor was irregular mucosa of mildly Depression, a handful of shallow ulcers, with the surrounding normal mucosa boundaries is not clear, endoscopic differentiation often poor; ② protruding : carcinogenesis mucosa thickening rough, slightly upwards, Part performance of plaque-like nodules or polyps, in well-differentiated adenocarcinoma accounted for the majority; ③ insidious type : mucosa lesions was darker, slightly coarse texture, in addition to generally did not change significantly, by histological examination before diagnosis is three - to - compare the earliest forms. (2) cardiac cancer tissue past gastric cancer tissue study, gastric ulcer, gastric polyps (adenomas) and chronic atrophic gastritis were considered to be the pre-cancerous gastric cancer lesions. In recent years, the study found several of the above happened very small chance of cancer. Especially in cardiac conditions than the three other parts of the stomach occurred less. So obviously the organization of cardiac and little happened. What is a recognition of the cardia cancer is the point of origin in the cardiac gland in the neck stem cells, have the potential direction of differentiation, Cardia can form or characteristics of the epithelial carcinoma. Most cardiac cancer optical microscopy, electron microscopy and Research Group found to be mixed, is the view of the strong support dysplasia is a precancerous lesion cardia cancer, it is also in the incidence of cardiac and related ulcers, polyps, atrophic gastritis were the key pathological process. When they occur dysplasia may change when cancer, which most colon-metaplasia with dysplasia in nature. The clinical and pathological cardiac cancer occurred in the 1987 International League revised UICC TNM staging of gastric cancer, its provisions are as follows (Table 1) : Table 1 TNM Classification of Cancer 0 Tis N0 M0 Ⅰ A period T1 N0 M0 stage IB T1 N1 M0 T2 N0 M0 Phase II N2 M0 T1 N1 M0 T3 T2 N0 M0 Ⅲ A N2 M0 T3 T2 N1 M0 T4 N 0 M0 III B T3 T4 N2 N2 M0 M0 Ⅳ T4 N2 M0 T-N-T M1 refers to the original tumor : Tis the epidermal carcinoma in situ which have not been invaded and lamina, T1 tumor invasion and lamina or mucosa, T2 tumors and myometrial invasion and subserosal, T3 tumors penetrating serosa (visceral peritoneum), below the adjacent structure, T4 tumor invasion and the adjacent structure (mean spleen, transverse colon, liver, diaphragm, pancreas, abdominal wall, adrenal, kidney, and the small intestine after peritoneal). N refers to the regional lymph nodes, N0 without regional lymph node metastasis, N1 weeks from stomach cancer within 3 cm surrounding lymph node metastasis, N2 weeks from stomach cancer than 3 cm surrounding lymph node metastasis, or along the left gastric, hepatic, splenic artery and the abdominal lymph node metastasis. M refers to distant metastasis, distant metastasis M0, M1 metastases. Also marked the site of metastasis, such as : lung for the PUL, for the OSS bone, liver for HEP, the brain of BRA, Peritoneal such as PER. Cancer Hospital Medical reports 937 cases cardia TNM staging information is available in 629 cases. Phase I of which 152 cases (24.1%), Phase II 179 cases (28.5%), Phase III 298 cases (47.4%). So to the hospital to seek medical treatment for cardiac 3 / 4 (75.9%) are II, III Phase, only about 1 / 4 of cases too early stage of the disease.