How is cardiac cancer classified

The incidence of cardia cancer is also high in areas with a high incidence of esophageal cancer in my country. According to statistics from these areas and tumor research and treatment institutions, the ratio of esophageal cancer to cardia cancer is about 2:1. The correct definition of cardia cancer is adenocarcinoma that occurs in the gastric cardia, that is, within about 2 cm below the esophageal-gastric junction. It is a special type of gastric cancer and should be distinguished from lower esophageal cancer. However, it is different from gastric cancer in other parts of the body. It has its own anatomical and histological characteristics and clinical manifestations, unique diagnostic and treatment methods, and poor surgical treatment effects.

Clinically, the gastrointestinal tract of advanced cardia cancer is generally divided into mushroom-like, ulcer type I, ulcer type II and invasive type. In this regard, experts divide cardia cancer into 4 types.

① Protruding type: The tumor is a mass with clear edges that bulges into the cavity, and is cauliflower-like, nodular, or polyp-like, and may have shallow ulcers;

② Localized ulcer type: The tumor is a deep ulcer, the marginal tissue is raised like a levee, and the boundary between the cut surface and the normal tissue is clear;

③ Infiltrative ulcer type: The edge of the ulcer is unclear, and the boundary between the cut surface and the surrounding tissue is unclear;

④ Infiltrative type: The tumor infiltrates and grows in the cardia wall. The affected area thickens evenly, with no boundary with the surrounding tissue, and the surrounding mucosa often shrinks radially.

The general classification of cardia cancer is related to the histological type. The protruding type and the localized ulcer type are mostly high-differentiated adenocarcinoma and mucinous adenocarcinoma. The proportion of low-differentiated adenocarcinoma and mucinous adenocarcinoma increases in the invasive ulcer type. The invasive type is mostly low-differentiated diffuse adenocarcinoma or mucinous adenocarcinoma. The prognosis of surgical treatment is the best in the protruding type, followed by the localized ulcer type, the poor in the invasive ulcer type, and the worst in the invasive type.

There are two main histological types of cardia adenocarcinoma: adenocarcinoma and mucinous adenocarcinoma with obvious mucus secretion. These two types are further divided into three subtypes according to the degree of differentiation: well-differentiated, poorly differentiated, and diffuse. The degree of differentiation is closely related to surgical prognosis. In addition to adenocarcinoma and mucinous adenocarcinoma, there are some rare histological types of cardia cancer, such as adenosquamous carcinoma, undifferentiated carcinoma, carcinoid (argentophilic cell carcinoma), and carcinosarcoma.