青年胃癌患者临床病理资料的回顾性分析

Clinicopathological features and prognosis of young patients with gastric cancer

目的:分析青年胃癌患者临床病理特点与预后之间的关系。方法:分析2007年1月至2009年6月本院手术治疗的653例胃癌患者资料,比较青年胃癌患者与老年胃癌患者临床病理特征及预后。结果:两组相比,青年组胃癌患者以女性多见,易累及全胃,BorrmannⅢ、Ⅳ型和印戒细胞癌的比例更高,分化程度更低,浸润程度更深,易出现腹痛,具有遗传因素(P<0.05)。青年组和老年组胃癌患者术后5年生存率分别为39.1%和56.6%,差异有统计学意义(P<0.05)。单因素和多因素预后分析显示,TNM分期和手术方式是影响青年胃癌患者预后的独立因素。结论:青年胃癌以高度恶性弥漫性为主,与遗传关系密切,易误诊漏诊,确诊时多为进展期,故应注重其早期筛查,早期诊断、根治性手术及相关治疗是提高其预后的关键。

Objective：To summarize the clinicoPathological characteristics and analyze the Prognostic factors of young Patients with gastric cancer. Methods：Clinical data of 653 Patients with gastric cancer admitted during January 2007 to June 2009 were retrosPectively reviewed. The clinical features and Prognosis of young Patients were comPared with elderly ones. Results：There were statistically significant differences in gender,tumor location,Borrmann tyPe, histological tyPe,differentiated histology,dePth of invasion,abdominal Pain,heredity between young Patients and elder ones（P〈0. 05）. The 5-year survival rates in young and elder Patients were 39. 1% and 56. 6%resPectively,and the difference was statistically significant（P〈0. 05）. Univariate and multivariate analyses showed that TNM stage and surgical methods were indePendent Predictive factors of survival for young Patients. Conclusion：The hereditary effect is significant in the young gastric carcinoma Patients,most of which are Poorly differentiated. Most Patients are in ad-vanced Phase and have a Poor Prognosis because of the high rate of misdiagnosis and missed diagnosis. Radical resec-tion aPPears to confer the only chance of Prolonged survival.