53例青年胃癌临床内镜病理分析

Clinical,endoscopic and pathological analysis of 53 young patients with gastric cancer

目的探讨青年胃癌临床、内镜及病理特征,为青年胃癌早期胃镜筛查提供依据。方法选择2002年10月至2012年10月胃镜检查并行病理活检证实胃癌患者621例,年龄≤40岁青年组53例,>70岁老年患者244例作为对照组,分析其临床、内镜及病理特征。结果青年组男女比例为1∶3.08,老年组3.36∶1,差异有统计学意义(P<0.05);青年组胃癌遗传倾向性多于老年组(P<0.05);青年组纳差、早饱及其他不典型症状者明显高于老年组(P<0.01);青年组胃癌以胃窦胃角部为主,老年组贲门及交界区为主,差异有统计学意义(P<0.05);青年组进展期胃癌BormannⅢ、Ⅳ型发现比例明显高于老年组(P<0.05);青年组低分化癌明显高于老年组,差异有统计学意义(P<0.01)。结论青年胃癌好发于女性,存在遗传倾向,可无特殊临床表现;发生部位以胃窦胃角为主;内镜以进展期胃癌为主;病理表现以低分化为主。应加强对青年胃癌临床内镜识别及早期筛查。

Objective To investigate the characteristics of clinical manifestations, endoscope and pathology in young patients with gastric cancer. Methods The clinical, endoscopic and pathological data of young group （53cases, ≤40 years） with gastric cancer con- filmed by pathology from October 2002 to October 2012 were reviewed and contrasted with those of old group（244 cases, 〉 70 years）during the same period. Results The male to female ratio was 1：3.08 in the young group and 3.36 ： 1 in elderly group, and there was a statistically significant difference（ P 〈 0.05 ）. The genetic predisposition of young group was higher than that of the old group （P 〈 0.05 ） . The inci- dences of anorexia, early satiety and other dyspepsia in young patients were higher than those of the old group （P 〈 0.01 ）. The occurrence sites of the tumors were gastric antruma and gastric angle in most of the young group, while the tumors of preventriculus and junctional zone were more common in the old one （ P 〈 0.05 ）. The incidence of the Borrmann Ⅲtype and Ⅳ type in young patients was statistically higher than that of the old group （ P 〈 O. 05 ）. As compared with the old group, young patients had more poorly differentiated carcinomas （ P 〈 0. 01 ）. Conclusion Young patients with gastric cancer are usually female, have obvious hereditary tendency, and are lacking in specific clini- cal manifestations. Their tumors usually locate at gastric antruma and gastric angle. Most of their endoscopic stages are advanced gastric canc- er and most of their pathological types are poorly differentiated carcinomas. We should raise the awarenes of youth gastric cancer and take ear- ly screening.