不同年龄段胃癌患者临床特征差异性分析

Analysis of the clinical characteristics among the gastric cancer patients of different age groups

目的分析不同年龄段胃癌患者临床特征的差异性,为胃癌的早期防治提供依据。方法回顾性分析本院2005年4月至2012年4月收治的598例原发性胃癌患者的临床资料。根据不同年龄段将入选患者分为青年组(≤40岁)、中年组(41~60岁)、老年组(>60岁),统计并分析三组患者的一般情况、诊断情况、肿瘤病理类型、手术方式及预后。结果青年组男性胃癌患者占比明显低于中年组和老年组(P<0.01);三组不同首发症状患者占比均无显著差异(P>0.05);青年组患者首诊方式以B超/CT为主,中年组和老年组患者首诊方式均以胃镜为主,青年组不同首诊方式患者占比与中年组和老年组比较具有显著差异(P<0.01);青年组患者误诊率明显高于中年组和老年组(P<0.01);青年组不同病理学分型患者占比与中年组和老年组比较具有显著差异(P<0.01);青年组Borrmann分型和远处转移患者占比与中年组和老年组具有显著差异(P<0.01),中年组淋巴结转移患者占比与青年组和老年组具有显著差异(P<0.01),但三组不同手术方式患者占比无显著差异(P>0.05);青年组患者1年、3年及5年生存率均显著低于中年组和老年组(P<0.01),老年组患者3年和5年生存率均显著低于中年组(P<0.05)。结论不同年龄段胃癌患者的临床病理特征具有相似性。早期胃癌误诊率较高,低分化类型较为多见。青年胃癌患者具有女性发病率高、恶性程度高、淋巴结转移和远处转移发生率高及预后差的特点。

Objective To compare the clinical characteristics among the gastric cancer patients of different age groups. Method Retrospective analyzed the clinical data of 598 patients with primary gastric cancer in our hospital from April 2005 to April 2012. These patients were divided into youth group（ ≤ 40 years old）, middle-age group（41 ~ 60 years old） and old-age group（ 60 years old）, analyzed the differences in the general situation, diagnosis, tumor pathologic type, operation method and prognosis among three groups. Result Youth group had obviously lower male ratio than middle-age group and old-age group（P〈0.01）; there was no significant difference in the proportion of different initial symptoms among three groups（P〈0.05）; ultrasound and CT were the mainly initial diagnosis way in youth group, and it was different from middle-age group and old-age group, whose mainly initial diagnosis way was gastroscope（P〈0.01）; the rate of misdiagnosis in youth group was significantly higher than that in middle-age group and old-age group（P〈0.01）; the proportion of different pathological classification in youth group was different from middle-age group and old-age group（P〈0.01）; the proportion of Borrmann type, lymph node metastasis and distant metastasis in youth group were significantly different from middle-age group and old-age group（P〈0.01）; the proportion of lymph node metastases in middle-age group was significantly different from that in youth group and old-age group（P〈0.01）; there was no significant difference in the proportion of surgical procedure among three groups（P〈0.05）; 1 year, 3 years and 5 years survival rate in youth group were significantly lower than middle-age group and old-age group（P〈0.01）. 3 years and 5 years survival rate in old-age group were both lower than that in middle-age group（P〈0.05）. Conclusion There are some similarity in the clinical pathological features among different age groups of gastric cancer, including the high rate of misdiagnosis and low differentiation types. Youth patient with gastric cancer has the special clinical pathological features, such as high incidence of women, high malignant degree, high incidence of lymph node metastasis, the distant metastasis and poor prognosis.