老年胃癌患者临床表现、病理特征和预后分析

Clinical Manifestations,Pathological Characteristics,and Prognostic Analysis in Elderly Patients with Gastric Cancer

目的:探讨老年胃癌患者临床表现、病理特征和预后分析。方法:选取2017年8月-2018年8月本院收治的接受手术治疗的102例老年胃癌患者作为老年组,选择同期接受手术治疗的80例中青年胃癌患者作为中青年组。分析两组的临床表现、病理特征及预后情况。结果:老年组男性占比高于中青年组,女性占比低于中青年组,差异有统计学意义(P<0.05)。两组肿瘤家族史情况比较,差异无统计学意义(P>0.05)。两组患者最常见的临床表现为上腹部不规律疼痛、黑便、呕血及贫血。老年组胸骨后不适、吞咽困难、腹部包块、消瘦发生率均明显高于中青年组,上腹部不规律疼痛低于中青年组,差异均有统计学意义(P<0.05)。预后良好组和预后不良组的典型临床特征、脑血管病史比较,差异均无统计学意义(P>0.05);预后良好组和预后不良组的TNM分期、分化程度、治疗方式、浸润深度、淋巴结转移比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,治疗方式、TNM分期、分化程度、浸润深度、淋巴结转移是影响老年胃癌患者预后的独立因素(P<0.05)。结论:老年胃癌患者在病理特征、临床表现以及预后等方面与中青年均存在较大不同,治疗方式、TNM分期、分化程度、浸润深度、淋巴结转移是影响老年胃癌患者预后的独立因素。

Objective:To investigate the clinical manifestations,pathological characteristics and prognosis analysis of elderly patients with gastric cancer.Method:A total of 102 elderly patients with gastric cancer who received surgical treatment in our hospital from August 2017 to August 2018 were selected as the elderly group,and 80 middle-aged and young patients with gastric cancer who received surgical treatment during the same period were selected as the middle-aged and young group.The clinical manifestations,pathological characteristics and prognosis of the two groups were analyzed.Result:The proportion of male in the elderly group was higher than that in the young and middle-aged group,while the proportion of female was lower than that in the young and middle-aged group,the difference was statistically significant(P<0.05).There was no significant difference in family tumor history between the two groups(P>0.05).The most common clinical manifestations in both groups were upper abdominal pain,black stools,hematemesis,and anemia.The incidence of retrosternal discomfort,dysphagia,abdominal mass and emasmus in the elderly group were significantly higher than those in the young and middle-aged groups,and the irregular pain in the upper abdomen was lower than that in the young and middle-aged groups,the differences were statistically significant(P<0.05).There were no significant differences in typical clinical features and cerebrovascular history between the good prognosis group and the poor prognosis group(P>0.05).Comparison of TNM stages,degree of differentiation,treatment methods,depth of infiltration and lymph node metastasis between the good prognosis group and the poor prognosis group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that treatment mode,TNM stage,degree of differentiation,depth of invasion and lymph node metastasis were independent factors affecting the prognosis of elderly gastric cancer patients(P<0.05).Conclusion:The pathological characteristics,clinical manifestations and prognosis of elderly patients with gastric cancer are significantly different from those of the middle-aged and young.Treatment mode,TNM stage,degree of differentiation,depth of invasion and lymph node metastasis are independent factors affecting the prognosis of elderly patients with gastric cancer.