Department of Gastroenterology, Kaiser Permanente Northern California, Santa Clara, CA, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
J Gastric Cancer. 2014 Dec;14(4):238-45. doi: 10.5230/jgc.2014.14.4.238. Epub 2014 Dec 26.
Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear.
We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups.
The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ≥70 years, P<0.0001), while more older patients were Caucasian (49% patients ≥70 years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ≥70 years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ≥70 years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ≥70 years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002).
Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.
胃癌常发生于老年人，但在年轻人中较为少见。目前尚不清楚年轻患者的临床行为和结局是否与老年患者不同。
我们从 Kaiser Permanente Northern California Cancer Registry 中确定了 2000 年至 2010 年间 1366 例新诊断的非贲门胃腺癌病例。然后，我们比较了不同年龄组的临床病理特征和生存情况。
年轻患者组和老年患者组的男女性别比差异有统计学意义（<50 岁患者为 0.84，>60 岁患者为 1.52，P<0.01）。更多的年轻患者为西班牙裔（<40 岁患者中 54%为西班牙裔，>70 岁患者中 19%为西班牙裔，P<0.0001），而更多的老年患者为白种人（>70 岁患者中 49%为白种人，<40 岁患者中 15%为白种人；P<0.0001）。弥漫/混合组织学类型在年轻患者中更为常见（<40 岁患者中 70%为弥漫/混合组织学类型，>70 岁患者中 27%为弥漫/混合组织学类型；P<0.0001），而肠型在老年患者中更为常见（>70 岁患者中 71%为肠型，<40 岁患者中 30%为肠型；P<0.0001）。年轻患者中低分化腺癌更为常见（<40 岁患者中 80%为低分化腺癌，>70 岁患者中 60%为低分化腺癌；P=0.016）。1、2、5 年生存率随年龄增长逐渐下降（总体 P=0.0002）。
与老年患者相比，年轻患者的胃癌侵袭性更强，但总体生存率更高。年轻的西班牙裔患者和老年的白种人患者更有可能被诊断为胃癌。这些差异可能是由于生物学倾向和/或环境暴露所致。
