青老年人胃癌的临床病理特点分析

Clinicopathologic characteristics of gastric cancer of young and old patients

目的 对青老年人胃癌的临床病理特点进行对比分析 ,预测青年人胃癌转移趋势及侵袭能力。方法 对 30例青年人 (≤ 35岁 )和 4 4 5例老年人 (≥ 6 5岁 )胃癌的临床病理资料进行分析。结果 青年组胃癌以女性多见 ,男女之比为 1∶1.6 ,老年组则为 3.6∶1。Borrmann’s分型青年组Ⅲ、Ⅳ型占 73.4 % ,老年组Ⅱ、Ⅲ型占86 .9%。从分化程度分析 ,青年组恶性程度较高 ,常有浆膜外浸润 ,占 70 % ,老年组浆膜外浸润占 35 .7%。癌周胃黏膜增生青年组 (4 0 % )高于老年组 (1.6 % )。淋巴结转移青年组 (83.3% )也高于老年组 (5 4 .8% )。结论 掌握青年人胃癌的临床病理特点 ,提高胃癌的早期诊断率 ,阻止其向晚期发展 ,是提高生存率的主要环节。

Objective To compare the pathologic characteristics of gastric cancer of young and old patients, and to predict the metastatic tendency and invasive capability. Methods To analyze the clinicopathologic data in 30 young (≤35 yrs) and 445 old patients (≥65 yrs) with gastric cancer.Results There were more females in young gastric cancer patients, the male : female ratio was 1:1.6, whereas among the old patients the ratio was 3.6:1. On Borrmann's classification in the young gastric cancer patients, type Ⅲ and Ⅳ being 73.4%, while in the old patients, Ⅱ and Ⅲ being 86.9%. As regards to the degree of differentiation, the young patients group had worser prognosis, higher degree of malignancy and frequently with infiltration beyond the serosa (70%). In the old age group, the prognosis was better, infiltration beyond the serosa layer was only 35.7%. Pericancerous mucosal hyperplasia was higher among the young patients (40%), higher than that in the old age group (1.6%). The lymph node metastasis was also higher in the former (83.3%) than in the latter (54.8%). Conclusion Handling the clinicopathologic characteristics of young gastric cancer patients, and promoting the early diagnostic rate of gastric cancer are important points in increasing the survival rate.