老年胃癌与青年胃癌临床及病理对比分析

Comparative Analysis of Clinicopathological Feature of the Gastric Can-cer in the Old and Young Patients

目的 探讨老年人及青年人胃癌临床及病理特征。方法 回顾性分析我院5年间79例老年胃癌(≥60岁),11例青年胃癌(≤40岁)患者的临床资料。结果 上腹痛,食欲减退,消瘦,贫血是其主要的消化道症状。老年组吞咽困难明显高于青年组(P<0.05),而呕吐、黑便则老年组低于青年组(P<0.05)。病程<3个月青年组明显高于老年组(P<0.05)胃癌发生部位:胃窦、胃角癌青年组高于老年组,贲门、胃底癌老年组高于青年组(P<0.05)。青年组多为Bonmann Ⅲ型、Ⅳ型,老年组多为Ⅰ型、Ⅱ型。病理组织学显示:青年组以低分化腺癌、粘液腺癌、印戒细胞癌为主,而老年组以中,高分化腺癌为主。随访结果:一年生存率青年组明显低于老年组。结论 青年组胃癌较老年组胃癌相比,其浸润能力强,恶性程度高,分化强度低,病情进展快,预后差。临床医师要提高对胃癌的认识及警惕性,特别是对青年胃癌的早期诊断。

Objective To study the clinicopathological feature of the gastric cancer in old and young patients. Methods The clinical information of 79 old patients (older than 60 years of age) and 11 young patients (younger than 40 years of age) in our hospital during a 5 year period was reviewed retrospectively. Results The epigastric pain, anorexia, weight loss, anaemia were main symptoms of enteron. The patients with dysphagia in the old group were significantly more than that in the young group( P < 0.05). But the vomiting and melena in tne old group were uncommoner than those in the young group ( P < 0.05). And the young group which the course of the disease was less than 3 months had statistical significances compared with the old group ( P < 0.05). The gastric tumour's location; the young group with the gastric carcinoma of autrum and angularis was more than the old group. But the old group with the gastric carcinoma of cardia and fun-dus was more than the young group ( P < 0.05). There were more patients of the young group with the gastric carcinoma of Bonmann type Ⅲ and Ⅳ, and more old patients with the gastric carcinoma of Bomnann type Ⅰ and Ⅱ . Using histopathology as the standard: the poorly differentiated carcinoma, adenocarcinoma, mucinous adenocarcinoma and signet-ring cell carcinoma were frequent in the young group. And the carcinoma in the old group was mainly well-differentiated adenocarcinoma. By a regular visit to these cases: the survival of one year of the young group was lower than that of the old group. Conclusions The gastric carcinoma in the young group, compared with the old group, has deeper invasion, poorer differentiation, higher malignity and faster advances. So the prognosis is worse. The physician must better the knowledge of the gastric carcinoma in the young patients and be alert to diagnosis it early.