青年胃癌患者的临床特点分析

Analysis of Clinical Features of Young Patients with Gastric Cancer

目的分析青年胃癌患者的临床、内镜及病理特征,探讨青年胃癌的发病特点。方法回顾性分析2005年4月~2016年4月于我院胃镜及病理诊断胃癌患者共650例资料。对青年(≤40岁,n=46)与老年(≥60岁,n=412)胃癌患者的临床资料进行分析,包括性别、年龄、BMI、个人史、家族史、临床症状、病变部位、胃镜下大体类型、组织学分化程度及TNM分期。结果与老年胃癌相比,青年胃癌中女性比例明显增高[47.8%(22/46)vs.29.1%(120/412),χ~2=6.764,P=0.009],胃癌肿瘤家族史明显增多[13.0%(6/46)vs.3.2%(13/412),χ~2=7.840,P=0.005],肿瘤更多位于远端胃[胃窦60.9%(28/46)vs.36.9%(152/412),χ~2=9.972,P=0.002]。内镜下大体分型上,青年胃癌BorrmannⅣ型比例明显增高[37.0%(17/46)vs.19.2%(79/412),χ~2=7.898,P=0.005];病理组织学分化程度上,青年胃癌大多分化程度低[87.0%(40/46)vs.49.3%(203/412),χ~2=23.594,P=0.000];肿瘤临床分期上,青年人胃癌患者Ⅳ期比例明显增高[41.3%(19/46)vs.25.5%(105/412),χ~2=5.245,P=0.022]。结论青年人胃癌中女性比例相对较高,有胃癌家族史更多,恶性程度更高,预后相对较差。

Objective To analyze the clinical characteristics,endoscopic feature and pathological findings of young patients with gastric cancer and to explore the characteristics of gastric cancer in young patients. Methods A total of 650 patients with gastric cancer diagnosed by endoscopy and pathology from April 2005 to April 2016 in our hospital were restrospectively analyzed. The data of young patients（ ≤40 years old,n = 46） and elderly patients（ ≥60 years old,n = 412） were compared. The statistical analysis were conducted to evaluate gender,age,BMI,personal history,family history,clinical symptoms,tumor location,gross type,histologic differentiation degree and TNM stages. Results As compared to the elderly group,the young group had significantly higher female ratio [47. 8%（ 22 /46） vs. 29. 1%（ 120 /412）,χ^2= 6. 764,P = 0. 009],significantly higher family history of gastric cancer [13. 0%（ 6 /46） vs. 3. 2%（ 13 /412）,χ^2= 7. 840,P = 0. 005 ],and more tumors located at the distal stomach [antrum：60. 9%（ 28 /46） vs. 36. 9%（ 152 /412）,χ^2= 9. 972,P = 0. 002]. In the endoscopic gross type,the young group had significantly higher Borrmann Ⅳ gastric cancer [37. 0%（ 17 /46） vs. 19. 2%（ 79 /412）,χ^2= 7. 898,P = 0. 005],worse differentiated histology[87. 0%（ 40 /46） vs. 49. 3%（ 203 /412）,χ^2= 23. 594,P = 0. 000],and significantly higher stage Ⅳ cases [41. 3%（ 19 /46） vs.25. 5%（ 105 /412）,χ^2= 5. 245,P = 0. 022]. Conclusion The young patients with gastric cancer have relatively higher female ratio,more family history of gastric cancer,worse differentiated histology,and relatively poor prognosis.