青年胃癌的临床特征及预后影响因素分析

Analysis of clinical characteristics and prognostic factors of gastric cancer in young patients

目的探讨青年胃癌的临床特征及其预后的影响因素。方法收集2013年1月~2017年12月安徽医科大学第一附属医院收治的胃癌患者临床资料,选取经手术治疗的94例Ⅰ~Ⅲ期青年胃癌患者(年龄≤40岁)作为研究组,通过倾向评分匹配(PSM)筛选94例中老年患者(年龄>40岁)作为对照组。比较两组临床资料,探究青年胃癌的临床特征,并分析评估青年胃癌的预后影响因素。结果研究组女性患者比例高于对照组,基础疾病少于对照组,组织学类型分化程度低于对照组,胃近端肿瘤的发病率低于对照组,差异有统计学意义(P<0.05)。两组术后各期累计生存率比较,差异无统计学意义(P>0.05)。单因素分析显示,肿瘤部位、肿瘤大小、淋巴结转移、TNM分期、大体分型、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原125(CA125)和糖类抗原(CA19-9)与青年胃癌的预后有关(P<0.05)。多因素分析显示,影响青年胃癌预后的独立危险因素为CA125阳性和进展期胃癌(P<0.05)。结论在基线特征匹配的情况下,青年胃癌患者中女性比例相对较高,肿瘤分化程度更低;CA125阳性和进展期胃癌是青年胃癌的不良预后因素。

Objective To explore the clinical characteristics and prognostic factors of gastric cancer in young patients.Methods Clinical data of patients with gastric cancer admitted to the First Affiliated Hospital of Anhui Medical University from January 2013 to December 2017 were collected.A total of 94 patients with stageⅠ-Ⅲgastric cancer(age≤40)were selected as the study group,and according to propensity score matching(PSM)method,94 middle-aged and elderly patients(age>40)were selected as the control group.The clinical data of the two groups were compared to explore the clinical characteristics of young gastric cancer and to analyze and evaluate the prognostic factors of young gastric cancer.Results The proportion of female patients in the study group was higher than that in the control group,the basic disease was less than that in the control group,the differentiation degree of histological type was lower than that in the control group,and the incidence of gastric proximal tumor was lower than that in the control group,and the differences were statistically significant(P<0.05).Univariate analysis showed that tumor location,tumor size,lymph node metastasis,TNM stage,gross classification,carcinoembryonic antigen(CEA),alphafetoprotein(AFP),carbohydrate antigen 125(CA125)and carbohydrate antigen 19-9(CA19-9)were related to the prognosis of young gastric cancer(P<0.05).CA125 positive and advanced gastric cancer were independent risk factors for prognosis based on the multivariate analysis(P<0.05).Conclusion In the case of matching baseline characteristics,the proportion of young patients with gastric cancer is relatively higher and the degree of tumor differentiation is lower,and CA125 positive and advanced gastric cancer are the poor prognostic factors of young gastric cancer.