Punjachaipornpon Thanachai, Mahachai Varocha, Vilaichone RathaKorn
Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand Email :
Asian Pac J Cancer Prev. 2016;17(7):3427-9.
Gastric cancer is the second leading cause of cancer death worldwide and occurs most frequently in the age group of 5070 years. Rarely reports have appeared regarding younger age groups. The purpose of this study was to compare clinical characteristics and outcome of treatment between young and elderly patients with gastric cancer in Thailand.
Clinical information, histological features, endoscopic findings and treatment outcome were reviewed and collected from Thammasat University Hospital, Pathumthani and Bangkok Medical Center, Bangkok, Thailand between September 2011March 2015.
A total of 154 gastric tumor patients including 101 with benign tumors (22 males and 79 females, mean age= 62.6 years) and 53 with gastric cancers (27 males and 26 females, mean age= 60.6 years) were enrolled in this study. Gastric cancer patients presented with alarm symptoms such as anemia, anorexia and weight loss significantly more frequently than benign gastric tumor patients. In gastric cancer patients, mean duration of symptoms prior to diagnosis was shorter in younger (<40 years) than older patients (age ≥40 years) (73.3 days vs 84.8 days). Family history of GI malignancy and diffuse type of gastric cancer were significant greater in younger than older patients (36% vs 5% P=0.01; OR= 11.4, 95%CI = 1.874.7 and 73% vs 14%, P<0.01; OR= 16, 95%CI = 3.378, respectively) and 5year survival rates were 9% in younger age patients and 19% in older age group.
Most young patients with gastric cancer in Thailand feature aggressive manifestations with poorer prognosis than elderly patients. Early detection of gastric cancer in high risk young patients might be important key to improve survival rate and treatment outcome in this particular group.
胃癌是全球癌症死亡的第二大主要原因，最常发生于50至70岁年龄组。关于较年轻年龄组的报道很少。本研究的目的是比较泰国年轻和老年胃癌患者的临床特征及治疗结果。
回顾并收集了2011年9月至2015年3月期间泰国巴吞他尼府的法政大学医院、曼谷的曼谷医疗中心的临床信息、组织学特征、内镜检查结果及治疗结果。
本研究共纳入154例胃肿瘤患者，其中101例为良性肿瘤（男性22例，女性79例，平均年龄=62.6岁），53例为胃癌（男性27例，女性26例，平均年龄=60.6岁）。与良性胃肿瘤患者相比，胃癌患者出现贫血、厌食和体重减轻等警示症状的频率明显更高。在胃癌患者中，年轻患者（<40岁）诊断前症状的平均持续时间比老年患者（年龄≥40岁）短（73.3天对84.8天）。年轻患者的胃肠道恶性肿瘤家族史和弥漫型胃癌显著多于老年患者（36%对5%，P=0.01；OR=11.4，95%CI=1.87至4.7；73%对14%，P<0.01；OR=16，95%CI=3.3至78），年轻患者的5年生存率为9%，老年组为19%。
泰国大多数年轻胃癌患者表现出侵袭性表现，预后比老年患者差。对高危年轻患者进行早期胃癌检测可能是提高这一特定群体生存率和治疗效果的重要关键。
