Song Shubin, Li Chunfeng, Li Sen, Cong Xiliang, Xue Yingwei
Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
Onco Targets Ther. 2017 Sep 27;10:4795-4802. doi: 10.2147/OTT.S144801. eCollection 2017.
Patients of different ages with gastric cancer (GC) have different clinicopathological features and prognoses. The results for different crowds are limited and controversial. The aim of this study was to investigate the differences in clinicopathological features and prognoses between younger and older GC patients.
From January 2007 to December 2011, a consecutive total of 112 GC patients under 41 years old and 358 GC patients over 69 years old who underwent gastrectomy for GC were recruited for this study. Then, the clinicopathological features and prognoses of these patients were analyzed comparatively.
The gender, differentiation, carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were significantly different between younger and older GC patients. There were more female and undifferentiated younger GC patients, and there were higher percentages of positive CA19-9 and CEA in older GC patients. The number of metastatic lymph nodes was an independent risk parameter for prognosis in younger patients, and the AJCC TNM (Tumor-Nodes-Metastases classification by American Joint Committee on Cancer) stage, radicality and tumor size were independent risk parameters for prognosis in older GC patients. Younger GC patients have a much better prognoses with lower monocyte-to-lymphocyte ratio and higher prognostic nutritional index than older patients.
Younger GC patients have better immunity and nutritional status and better prognoses. The number of metastatic lymph nodes was the only risk parameter for prognosis in younger GC patients. We should take more effective treatments for younger GC patients with lymph nodes metastasis and pay more attention to the nutritional problems of older GC patients.
不同年龄段的胃癌（GC）患者具有不同的临床病理特征和预后。针对不同人群的研究结果有限且存在争议。本研究旨在探讨年轻与老年GC患者在临床病理特征和预后方面的差异。
选取2007年1月至2011年12月期间因GC接受胃切除术的112例41岁以下的GC患者和358例69岁以上的GC患者。然后，对这些患者的临床病理特征和预后进行比较分析。
年轻与老年GC患者在性别、分化程度、糖类抗原（CA）19-9和癌胚抗原（CEA）方面存在显著差异。年轻GC患者中女性和未分化患者更多，而老年GC患者中CA19-9和CEA阳性率更高。转移淋巴结数量是年轻患者预后的独立风险参数，而美国癌症联合委员会（AJCC）TNM（肿瘤-淋巴结-转移分类）分期、根治性和肿瘤大小是老年GC患者预后的独立风险参数。年轻GC患者的预后明显优于老年患者，其单核细胞与淋巴细胞比值更低，预后营养指数更高。
年轻GC患者具有更好的免疫和营养状况以及更好的预后。转移淋巴结数量是年轻GC患者预后的唯一风险参数。对于有淋巴结转移的年轻GC患者，我们应采取更有效的治疗措施，并更多地关注老年GC患者的营养问题。
