Lu Chong, Wang Zhen-ning, Sun Zhe, Xu Hui-mian
Department of Surgical Oncology, the First Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Wai Ke Za Zhi. 2008 Oct 1;46(19):1468-71.
To analyze the clinicopathologic features and prognosis of young patients with gastric cancer by comparing with older patients.
The clinicopathologic data of 157 younger adults (age, </= 40 years) with gastric cancer and 1761 cases of elder gastric cancer patients (age, > 40 years) was analyzed and compared retrospectively. All of the 1918 patients were surgically treated between January 1980 and December 2000.
The rates of poorly differentiation, diffusive growth, Borrmann 4 type, whole-stomach invasion were significantly higher in younger cases than those in the elder counterparts (P < 0.05), especially in young female patients. The rate of early gastric cancer was significantly higher in young patients than that in older patients (P < 0.05), especially in young male patients. There was significant difference between the survival rate of younger male cases (median survival, 35 months) and younger female cases (median survival, 19 months) (P = 0.0219), but no significant difference was found between elder male and elder female (median survival, 26 vs. 30 months). TNM stage, operative curability, gross type were independent predictive factors of survival for younger patients.
Younger female gastric cancer patients tends to have worse prognosis than older patients, while younger male patients have better prognosis due to higher percentage of early gastric cancer when diagnosed. Pathologic staging and operative curability are the independent predictive factors of survival for younger patients.
通过与老年患者对比，分析青年胃癌患者的临床病理特征及预后情况。
回顾性分析157例年龄≤40岁的青年胃癌患者及1761例年龄＞40岁的老年胃癌患者的临床病理资料。所有1918例患者均于1980年1月至2000年12月期间接受手术治疗。
青年患者中低分化、弥漫性生长、Borrmann 4型、全胃侵犯的发生率显著高于老年患者（P＜0.05），尤其在青年女性患者中更为明显。青年患者早期胃癌的发生率显著高于老年患者（P＜0.05），尤其在青年男性患者中。青年男性患者（中位生存期35个月）与青年女性患者（中位生存期19个月）的生存率存在显著差异（P = 0.0219），但老年男性与老年女性之间（中位生存期分别为26个月和30个月）未发现显著差异。TNM分期、手术可切除性、大体类型是青年患者生存的独立预测因素。
青年女性胃癌患者的预后往往比老年患者差，而青年男性患者由于确诊时早期胃癌比例较高，预后较好。病理分期和手术可切除性是青年患者生存的独立预测因素。
