青年人胃癌的临床研究

A clinical study on gastric carcinoma in young patients

目的探讨青年人胃癌的发病特点及临床病理特征。方法回顾分析64例青年人胃癌(≤35岁)和185例老年人胃癌(≥60岁)的临床资料。比较两组患者的临床症状、幽门螺杆菌(Hp)感染、病变部位、病程、Borrmann分型、病理类型及预后。结果青年组胃癌女性多发,男女之比为1∶1.78,临床首发症状以上腹部疼痛、上腹部饱胀等为主,Hp感染率明显高于老年组(P<0.05);青年组病程以<3个月、老年组以>6个月为主(P<0.01)。青年组胃癌发病部位以胃窦为主,老年组以胃底贲门多见(P<0.01)。青年组病理类型以BorrmannⅢ、Ⅳ型和低分化腺癌多见,老年组以高分化腺癌居多(P<0.01或P<0.05)。5年生存率青年组低于老年组(P<0.05)。结论与老年人胃癌相比,青年人胃癌恶性程度高,分化低,进展速度快,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 investigate the clinical symptoms and the clinico - pathological characteristics in young patients with gastric carcinoma. Methods The clinical pathological records of 64 young patients （aged 35 years or younger） and 185 elderly patients （aged 60 years or older） were retrospectively analyzed. Clinical rnanifestation, Helicobacter pylori infection, lesion location, disease course, between the two groups were analytically compared. tients, the ratio of male to female was 1 ： 1.78. There the first occurred clinical manifestation. Helicobacter Results Borrmann typing, pathological type and prognosis In the youth group, there were more female pawere more cases with epigastrium pain, epigastrium distend as pylori infection cases in youth group were significantly more than those in elderly group （ P 〈0.05）. Duration of disease in the youth group was less than 3 months, and the elderly group was longer than 6 months （ P 〈0.01）. The tumor sites of origin in the youth group were mainly located in gastric sinus, and the elderly group mainly in gastric cardia （ P 〈0.01）. Pathologic features, Borrmann Ⅲ or Ⅳ and poorly differentiated adenocarcinoma were prevalent in the youth group, and well differentiated ad were prevalent in the elderly group（ P 〈0.01 or P 〈 0.05）. The 5 youth group than that in elderly group （ P 〈 0. 05）. Conclusion - year survival rate was obviously lower in the Compared to the elderly, young patients with gastric carcinomas carry worse degree, lower differentiation, faster progress and tx）orer prognosis. Early identification, radical resection treatment are necessary to improve curative and survival rates for young patients.