The Correlation Between The Endoscopic Features And The Clinicopathological Characteristics Of Adenocarcinomas Of Adenocarcinomas Of The Esophagogastric Junction

[Background]In recent years,compared with the distal gastric cancer,the incidence of adenocarcinomas of the esophagogastric junction(AEG)has increased.Most patients with AEG have been diagnosed at a late stage,and the 5 year survival rate is not high even if surgical treatment is performed.Therefore,the early detection and diagnosis of AEG is particularly important.At the same time,with the development of endoscopic treatment technology,early AEG without metastasis of lymph node and shallow invasion can be removed under endoscope.Accurate evaluation of the depth of invasion before operation is important to choose a reasonable treatment[Objective]1.Evaluate the value of endoscopy and biopsy in the diagnosis of AEG.2.Discuss the correlation between metastasis of lymph node and clinicopathological characteristics of AEG.3.Evaluate the value of gastroscope biopsy in the the diagnosis of AEG[Methods]1.A total of 205 patients of AEG in our hospital were collected with the preoperative biopsy and postoperative pathology from august 2013 to December 2017.2.Collected the clinical data?gastroscopic images and postoperative pathology of 145 patients with AEG in our hospital in recent years,analyze the relationship between lymph node and clinicopathological characteristics.[Results]1.The overall consistency rate of biopsy and postoperative pathological was 64.9%(133/205).The overall consistency rate of endoscopic combined biopsy and postoperative pathological was 98.5%(203/205).The results of 34.6%(71/205)cases of postoperative were worse than the biopsy.2.The positive rate of metastasis of lymph node was 46.9%,age,tumor location?depth of invasion,degree of differentiation,lesion morphology,tumor size and lymph node metastasis of AEG were statistically significant.There is no statistical significance between sex and lymph node metastasis of AEG,Logistic multivariate analysis showed that the depth of infiltration was an independent risk factor for lymph node metastasis.3.Elderly patients,lesions greater than 3cm combined with mucosal redness,surface roughness,marginal uplift and undifferentiated lesions indicated deep invasion of the lesion.While other factors,including gender,tumor location,morphological type,were not related factors.Logistic multivariate analysis showed that the marginal uplift and undifferentiated lesions were independent risk factors in the depth of tumor invasion.The DPS score used in assessment of invasive depth of 94 differentiated carcinomas,10 cases of error,the accuracy rate was 90.43%.[Conclusions]1.There is a great difference between the diagnosis of biopsy and postoperative pathological,Biopsy combined with endoscopy can improve the accuracy of diagnosis?when necessary,combined with ESD can provide reliable basis for clinical treatment specification.2.Early diagnosis and treatment for AEG can reduce the rate of lymph node metastasis and improve the prognosis.3.We should pay attention to the high incidence of early AEG,and strengthen biopsy for suspicious lesions.DPS can assist in judging the depth of invasion of early differentiated AEG...