AIM:To evaluate the epidemiologic features of young age gastric cancer(GC). METHODS:Retrospectively,a total of 3242 patients with GC between 18 and 45 years of age and 3000 sex-and age-matched controls were reviewed.A...AIM:To evaluate the epidemiologic features of young age gastric cancer(GC). METHODS:Retrospectively,a total of 3242 patients with GC between 18 and 45 years of age and 3000 sex-and age-matched controls were reviewed.All subjects were stratified into 3 groups based on age (A,18-30 years;B,31-40 years;C,41-45 years). Epidemiologic characteristics and risk factors were investigated with reference to their age and gender. RESULTS:Compared to controls,more frequent intake of high risk diet(P=0.00075),history of heavy smoking(P=0.00087),intake of heavy alcohol(P= 0.00091),lower social economic status(P=0.00083), body mass index>30(P=0.00097),urban residence(P=0.00065),and more frequent exposure to harmful occupational environments(P=0.00072)were observed in all age groups and both genders in young age GC.These relationships were weaker in females compared to males of the same age,and were stronger as the age of patients increased.However,in group C of young age GC patients,environmental factors played important roles in females and males with a similar body weight.In females,older age at first delivery(> 35 years),lack of lactation history,nulliparity,and poor nutritional status during pregnancy were significantly associated with an increased risk of GC(P=0.00034). In this study,252 patients(7.8%)had a family history of GC with high odds ratio(OR)(3.22-4.21).In particular, family history was more closely associated with GC in males(OR,4.21 in male vs 3.46 in female)and more advanced cases(P=0.00051). CONCLUSION:Hormonal associated factors were more commonly associated with females whereas environmental factors were more commonly associated with males in young age GC patients.展开更多
The incidence of gastric cancer (GC) in young patients has showed a stable or even slightly increasing trend in recent years all over the world. Little is known about the clinicpathological features of young patients ...The incidence of gastric cancer (GC) in young patients has showed a stable or even slightly increasing trend in recent years all over the world. Little is known about the clinicpathological features of young patients with GC in Ningxia region, located in the northwest part of China. To define the clinicpathological features of GC in young patients in this region, 117 patients with GC, who were admitted to the Department of Medical Oncology, General Hospital of Ningxia Medical University, Ningxia, China, were enrolled in a retrospective database between 2000 and 2005. The data from 55 patients aged less than 35 years old were compared with those from 62 controls aged between 36 and 70. It was found that in young group, the percentages of females, the tumors in the lower third of the stomach, tumor size larger than 4 cm, macroscopic type Borrmann III tumors, poorly differentiated histology, the 7th?T stage T3 + T4, the distribution of tumor-nodes-metastasis(TNM)stage IV, surgical exploratory laparoscopy, and anemia symptoms were significantly higher than those in the control group (P?< 0.05). The 5-year survival in the young group was lower than that in the control group (21.8%?vs.?48.4%,?P?< 0.05). It was obvious that the clinicpathological features of GC in young patients were different from those in the control group. Focusing on early diagnostic rate and choosing a suitable operative treatment should be critical to improve prognosis of young patients with GC in Ningxia region of China.展开更多
Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric can...Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric cancer in young people (14–35 years). Results: The clinical manifestations of gastric carcinoma in young people show no specificity, and the initial symptoms were diverse, with discomfort in the upper abdomen as the main symptom. There are four causes of difficulty in early detection: (1) The previous physician relied on antacids and did not use or analyze the results of gastroscopic examination and barium meal examination of the upper digestive tract; (2) The physician performing the endoscopic examination did not strictly follow the standards in the biopsy of fine pathological changes in suspected early cancer; (3) The physician lacked a good understanding of the clinical progress of ulcerating-healing-ulcerating in the ulcerating type of early gastric cancer; (4) Lacked a good understanding of precancerous lesions in the gastric mucosa. Conclusion: Early gastroscopy and pathological examina- tion must be conducted for people who above 20 years of age with one or more of the following symptoms: dull pain in the upper abdomen, anorexia, fatigue, tarry stool and vomiting of unknown origin. The results of gastroscopic examination should be taken into consideration for patients with recurrent ulcer, and biopsy should be standardized. Biopsy specimens should be taken from several loci in the suspected lesions, and should be repeated if necessary. Precancerous lesions of gastric mucosa should be closely followed up using gastroscopy.展开更多
The final contest of 2015 Chinese Young Surgeon Contest--surgery fur gastric cancer was successfully held in Beijing International Conference Center on 27th June, 2015. After the exciting contest among the 12 finalist...The final contest of 2015 Chinese Young Surgeon Contest--surgery fur gastric cancer was successfully held in Beijing International Conference Center on 27th June, 2015. After the exciting contest among the 12 finalists, the first prize, Theodor Billroth Prize, was taken by Xian Shen from the First Affiliated Hospital of Wenzhou Medical University in Open Group, and Jian Zhang from Hangzhou First People＇s Hospital in Endoscope Group.展开更多
Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma d...Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.展开更多
文摘AIM:To evaluate the epidemiologic features of young age gastric cancer(GC). METHODS:Retrospectively,a total of 3242 patients with GC between 18 and 45 years of age and 3000 sex-and age-matched controls were reviewed.All subjects were stratified into 3 groups based on age (A,18-30 years;B,31-40 years;C,41-45 years). Epidemiologic characteristics and risk factors were investigated with reference to their age and gender. RESULTS:Compared to controls,more frequent intake of high risk diet(P=0.00075),history of heavy smoking(P=0.00087),intake of heavy alcohol(P= 0.00091),lower social economic status(P=0.00083), body mass index>30(P=0.00097),urban residence(P=0.00065),and more frequent exposure to harmful occupational environments(P=0.00072)were observed in all age groups and both genders in young age GC.These relationships were weaker in females compared to males of the same age,and were stronger as the age of patients increased.However,in group C of young age GC patients,environmental factors played important roles in females and males with a similar body weight.In females,older age at first delivery(> 35 years),lack of lactation history,nulliparity,and poor nutritional status during pregnancy were significantly associated with an increased risk of GC(P=0.00034). In this study,252 patients(7.8%)had a family history of GC with high odds ratio(OR)(3.22-4.21).In particular, family history was more closely associated with GC in males(OR,4.21 in male vs 3.46 in female)and more advanced cases(P=0.00051). CONCLUSION:Hormonal associated factors were more commonly associated with females whereas environmental factors were more commonly associated with males in young age GC patients.
文摘The incidence of gastric cancer (GC) in young patients has showed a stable or even slightly increasing trend in recent years all over the world. Little is known about the clinicpathological features of young patients with GC in Ningxia region, located in the northwest part of China. To define the clinicpathological features of GC in young patients in this region, 117 patients with GC, who were admitted to the Department of Medical Oncology, General Hospital of Ningxia Medical University, Ningxia, China, were enrolled in a retrospective database between 2000 and 2005. The data from 55 patients aged less than 35 years old were compared with those from 62 controls aged between 36 and 70. It was found that in young group, the percentages of females, the tumors in the lower third of the stomach, tumor size larger than 4 cm, macroscopic type Borrmann III tumors, poorly differentiated histology, the 7th?T stage T3 + T4, the distribution of tumor-nodes-metastasis(TNM)stage IV, surgical exploratory laparoscopy, and anemia symptoms were significantly higher than those in the control group (P?< 0.05). The 5-year survival in the young group was lower than that in the control group (21.8%?vs.?48.4%,?P?< 0.05). It was obvious that the clinicpathological features of GC in young patients were different from those in the control group. Focusing on early diagnostic rate and choosing a suitable operative treatment should be critical to improve prognosis of young patients with GC in Ningxia region of China.
文摘Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric cancer in young people (14–35 years). Results: The clinical manifestations of gastric carcinoma in young people show no specificity, and the initial symptoms were diverse, with discomfort in the upper abdomen as the main symptom. There are four causes of difficulty in early detection: (1) The previous physician relied on antacids and did not use or analyze the results of gastroscopic examination and barium meal examination of the upper digestive tract; (2) The physician performing the endoscopic examination did not strictly follow the standards in the biopsy of fine pathological changes in suspected early cancer; (3) The physician lacked a good understanding of the clinical progress of ulcerating-healing-ulcerating in the ulcerating type of early gastric cancer; (4) Lacked a good understanding of precancerous lesions in the gastric mucosa. Conclusion: Early gastroscopy and pathological examina- tion must be conducted for people who above 20 years of age with one or more of the following symptoms: dull pain in the upper abdomen, anorexia, fatigue, tarry stool and vomiting of unknown origin. The results of gastroscopic examination should be taken into consideration for patients with recurrent ulcer, and biopsy should be standardized. Biopsy specimens should be taken from several loci in the suspected lesions, and should be repeated if necessary. Precancerous lesions of gastric mucosa should be closely followed up using gastroscopy.
文摘The final contest of 2015 Chinese Young Surgeon Contest--surgery fur gastric cancer was successfully held in Beijing International Conference Center on 27th June, 2015. After the exciting contest among the 12 finalists, the first prize, Theodor Billroth Prize, was taken by Xian Shen from the First Affiliated Hospital of Wenzhou Medical University in Open Group, and Jian Zhang from Hangzhou First People＇s Hospital in Endoscope Group.
文摘Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.
