Qiu Miao-zhen, Wang Zhi-qiang, Zhang Dong-sheng, Luo Hui-yan, Zhou Zhi-wei, Wang Feng-hua, Li Yu-hong, Jiang Wen-qi, Xu Rui-hua
State Key Laboratory of Oncology in South China, Guangzhou 510060, China.
Tumour Biol. 2011 Jun;32(3):509-14. doi: 10.1007/s13277-010-0145-2. Epub 2010 Dec 23.
The incidence of gastric cancer in young has increased steadily in the last decades. Little is known about the clinicopathologic features and prognostic factors of young adult gastric cancer patients. The clinicopathological characteristics of 294 young adult gastric cancer patients between 20 and 50 years old were reviewed retrospectively from hospital records in Sun Yat-Sen University Cancer Center between 1996 and 2006. They were compared with 706 elder patients 51 years of age or over. A steady increasing in the proportion of female in the gastric carcinoma patients as the age decreasing was found. The distinguishing histological features of young adult patients were higher percentage of poorly differentiated grade and distant metastasis. The distribution of tumor-nodes-metastasis (TNM) stage was similar between these two groups. The 5-year disease-specific survival rate in the young adult group was significantly higher than in the elderly group. More patients receiving adjuvant chemotherapy were found in the young adult group. Multivariable analysis demonstrated that TNM stage and presence of angiolymphatic invasion were the independent negative predictors of survival for young patients with gastric cancer. Gastric cancer in young patients differs from that in elderly patients including a lack of male predilection, more aggressive histologic features, and better survival rate.
在过去几十年中,年轻人群胃癌的发病率呈稳步上升趋势。关于年轻成年胃癌患者的临床病理特征和预后因素,我们所知甚少。回顾性分析了1996年至2006年间中山大学肿瘤防治中心收治的294例年龄在20至50岁之间的年轻成年胃癌患者的临床病理特征,并与706例51岁及以上的老年患者进行比较。结果发现,随着年龄的降低,女性胃癌患者的比例呈稳步上升趋势。年轻成年患者的显著组织学特征是低分化程度和远处转移的比例更高。两组患者的肿瘤-淋巴结-转移(TNM)分期分布相似。年轻成年组的5年疾病特异性生存率显著高于老年组。年轻成年组接受辅助化疗的患者更多。多变量分析表明,TNM分期和血管淋巴管侵犯是年轻胃癌患者生存的独立负性预测因素。年轻患者的胃癌与老年患者的胃癌不同,包括缺乏男性偏好、组织学特征更具侵袭性以及生存率更高。