青年人胃癌临床病理特征及误诊原因分析

The clinicopathological characteristics and cause of misdiagnosis analysis of gastric carcinoma in young patients

目的：总结分析青年人胃癌的临床病理特征，探讨青年人胃癌的发病特点及误诊原因。方法：回顾性分析2000年1月～2006年12月间手术治疗的36例青年人胃癌（≤35岁）的临床资料。结果：35岁以下青年人胃癌占同期胃癌的2．4％，男女比例1：1.12，临床首发症状以上腹部疼痛、上腹部饱胀、消瘦乏力、反酸嗳气等为主，胃窦部癌多发，占61．1％，病程多在3～6个月，病理类型以Borrmann III型和低分化腺癌多见，病灶多在4cm以上，手术治疗方式上与中老年无显著性差异，5年生存率仅6．1％。结论：青年人胃癌首发临床症状隐匿，误诊率高，病程短，进展速度快，恶性程度高，手术根治率低，预后差，早期发现、尽早实施根治手术切除是提高治愈率和生存率的关键。

Objective：To summarize the clinicopathological characteristics with gastric carcinoma in young patients and explore the features of morbility and the cause of misdiagnosis. Methods： The clinic pathological data of the 36 young patients （ = 35 years of age） with gastric carcinoma been treated by operation from January 2000 to December 2006 were retrospectively analyzed. Resuits：The overall, the incidence rate of the patients younger than 35 was 2. 4%. The rate of male-to-female was 1： 1.12. There were more cases with epigastrium pain, epigastrium distend, emaciation debilitation, sour regurgitation and belching as the first clinical manifestations occurred. Incidence rate of disease course lasting for 3mon～6mon. Gastric antrum cancer was prevalent, account of 61.1%. Pathologic features, Borrmann m and poorly differentiated adenocarcinomar were prevalent. Majority focus more than 4cm. There was no significant difference between radical resection rate and palliation resection rate in two groups. The 5-year survival rates of young patients were lower, only 6. 1%. Conclusion：Young patients with gastric carcinomar were lack of specificity clinical symptoms, disease course short, fast progress, high malignancy and misdiagnosis, low radical rate and bad prognosis. Early discovery, radical resection treatment are necessary to elevate cure rates and survival rates for young patients.