671例老年人胃癌临床和病理特点分析

Clinical and Pathologic Characteristics of Gastric Cancer in Old Patients:a Retrospective Study of 671 Patients

目的研究老年人胃癌的临床和病理特点,为早期诊断和治疗提供依据。方法对我院1998年1月～2005年12月经内镜发现病理确诊的671例老年人胃癌患者(>60岁)与126例青年人胃癌患者(<35岁)进行回顾性分析,比较两组的临床特征和病理特点。结果老年人胃癌男性发病率明显高于女性(P<0.01),但在青年人发病率无明显性别差异;老年人胃癌多见消瘦、呕血和黑便,青年人胃癌患者以上腹痛和恶心呕吐为主;胃癌部位,老年人以胃底贲门部为主,而青年人以胃窦部多见(P<0.01);病理组织类型老年人以中分化腺癌(47.84%)为主,青年人胃癌则以低分化腺癌为(53.2%)。结论掌握老年人胃癌的临床和病理特点,有助于早发现、早诊断、早治疗,以提高患者的存活率。

Objective To analyze the difference in clinical and pathologic characteristics of gastric cancer in young and old patients. Methods A retrospective study of 797 gastric cancer patients diagnosised by endoscopic and histological was performed. There were 671 patients in the old age group （age 〉 60 years） and 126 in the young age group （age≤35 years）. The clinical and pathologic parameters for this study included sex, clinical manifestations, gross type, location and histologic type. Results The old patients had a higher percentage of sex ratio, whereas no significant difference was found in the yong age group. In the old age group, large amount of cancers were found in cardiac and fundus of stomach, while those were found in antrum in young group （P 〈0.01 ）. Moderately differentiated and poorly differentiated adenocarcinoma were detected in 321 （47.84%） and 195 （29. 1% ） of the 671 old patients, respectively, while there were 22 （21.4%） and 67 （53.2%） in the young age group. Conclusions These results indicate that, in the old age group, gastric cancers showed significant difference from the young age group in clinical and pathologic feature. These findings have important implications for the screening and diagnosis of gastric cancer in the elderly.