Abstract：
Recent genomic studies suggest that esophageal adenocarcinoma (EAC) is not homogeneous and can be divided into true (tEAC) and probable (pEAC) groups. We compared clinicopathologic and prognostic features between the two groups of EAC. Based on endoscopic, radiologic, surgical, and pathologic reports, tumors with epicenters beyond 2 cm of the gastroesophageal junction (GEJ) were assigned to the tEAC group (N = 63), while epicenters within 2 cm of, but not crossing the GEJ, were allocated to the pEAC group (N = 83). All 146 consecutive patients were male (age: median 70 years, range: 51-88) and White-predominant (98.6 %). There was no significant difference in gastroesophageal reflux disease, obesity, comorbidity, and the prevalence of Barrett\'s esophagus, and cases diagnosed during endoscopic surveillance. However, compared to the pEAC group, the tEAC group had significantly more cases with hiatal hernia (P = 0.003); their tumors were significantly smaller in size (P = 0.007), more frequently with tubular/papillary adenocarcinoma (P = 0.001), had fewer cases with poorly cohesive carcinoma (P = 0.018), and demonstrated better prognosis in stage I disease (P = 0.012); 5-year overall survival (34.9 months) was significantly longer (versus 16.8 months in pEACs) (P = 0.043). Compared to the patients without resection, the patients treated with endoscopic or surgical resection showed significantly better outcomes, irrespective of stages. We concluded that EACs were heterogeneous with two distinct tEAC and pEAC groups in clinicopathology and prognosis; resection remained the better option for improved outcomes. CONDENSED ABSTRACT: Esophageal adenocarcinoma can be divided into true or probable groups with distinct clinicopathology and better prognosis in the former than in the latter. we showed that resection remained the better option for improved outcomes.
摘要：
最近的基因组研究表明，食管腺癌（EAC）不是同质的，可以分为真实（tEAC）和可能（pEAC）组。我们比较了两组EAC的临床病理和预后特征。基于内窥镜，放射学,外科,和病理报告，具有超过胃食管交界处2厘米（GEJ）的中心的肿瘤被分配到tEAC组（N=63），而震中在2厘米以内，但不能穿过GEJ，被分配到pEAC组(N=83)。所有146例连续患者均为男性（年龄：中位数70岁，范围：51-88）和白人占主导地位（98.6%）。胃食管反流病无显著差异,肥胖，合并症，以及Barrett食管的患病率,和内镜监测期间诊断的病例。然而,与PEAC组相比，tEAC组的食管裂孔疝病例明显增多（P=0.003）；肿瘤大小明显较小（P=0.007），更常见的是管状/乳头状腺癌（P=0.001），有较少的病例与低粘性癌（P=0.018），并且在I期疾病中显示出更好的预后（P=0.012）;5年总生存期（34.9个月）明显更长（pEACs为16.8个月）（P=0.043）。与未切除的患者相比，接受内镜或手术切除治疗的患者显示出明显更好的结局，无论阶段。我们得出的结论是，在临床病理和预后方面，EACs具有两个不同的tEAC和pEAC组；切除仍然是改善预后的更好选择。摘要：食管腺癌可分为真实或可能的组，前者的临床病理特征不同，预后较后者好。我们表明,切除仍是改善结局的更好选择.
