Li Qingguo, Zhuo Changhua, Cai Guoxiang, Zheng Hongtu, Li Dawei, Cai SanJun
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
PLoS One. 2014 Jul 8;9(7):e102004. doi: 10.1371/journal.pone.0102004. eCollection 2014.
To compare the pathological features and survival outcomes at different age subgroups of young patients with colon cancer.
Using Surveillance, Epidemiology, and End Results (SEER) population-based data, we identified 2,861 young patients with colon cancer diagnosed between 1988 and 2005 treated with surgery. Patients were divided into four groups: group 1 (below 25 years), group 2 (26-30 years), group 3 (31-35 years) and group 4 (36-40 years). Five-year cancer specific survival data were obtained. Kaplan-Meier methods were adopted and multivariable Cox regression models were built for the analysis of long-term survival outcomes and risk factors.
There were significant different among four groups in pathological grading, histological type, AJCC stage, current standard (≥12 lymph nodes retrieval), mean number of lymph nodes examined and positive lymph nodes (p<0.001). The 5-year cause specific survival was 71.0% in group 1, 75.1% in group 2, 80.6% in group 3 and 82.5% in group 4, which had significant difference in both univariate (P = 0.002) and multivariate analysis (P = 0.041).
Young patients with colon cancer at age 18-40 years are essentially a heterogeneous group. Patients at age 31-35, 36-40 subgroups have more favorable clinicopathologic characteristics and better cancer specific survival than below 30 years.
比较青年结肠癌患者不同年龄亚组的病理特征和生存结局。
利用基于监测、流行病学和最终结果（SEER）的人群数据，我们确定了1988年至2005年间诊断为结肠癌并接受手术治疗的2861例青年患者。患者分为四组：第1组（25岁以下）、第2组（26 - 30岁）、第3组（31 - 35岁）和第4组（36 - 40岁）。获得了5年癌症特异性生存数据。采用Kaplan - Meier方法并建立多变量Cox回归模型，用于分析长期生存结局和危险因素。
四组在病理分级、组织学类型、美国癌症联合委员会（AJCC）分期、现行标准（≥12枚淋巴结清扫）、平均检查淋巴结数和阳性淋巴结方面存在显著差异（p<0.001）。第1组的5年病因特异性生存率为71.0%，第2组为75.1%，第3组为80.6%，第4组为82.5%，单因素分析（P = 0.002）和多因素分析（P = 0.041）均有显著差异。
18 - 40岁的青年结肠癌患者本质上是一个异质性群体。31 - 35岁、36 - 40岁亚组的患者比30岁以下患者具有更有利的临床病理特征和更好的癌症特异性生存。
