Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Acta Med Okayama. 2020 Dec;74(6):461-466. doi: 10.18926/AMO/61204.
Gastric cancer usually arises in middle-aged to older patients, and is rarely found in younger patients. The clin-ical characteristics, etiology, prognosis, preventive methods and treatment of gastric cancer in young patients have not been fully investigated because of its low prevalence. In this review, we discuss the current under-standing and clinical problems associated with gastric cancer in young patients. Helicobacter pylori (H. pylori), which is a major cause of gastric cancer, especially in older populations, is closely associated with gastric cancer in young patients as well as in older patients. Gastric cancer in young patients tends to be diagnosed at an advanced stage with alarm symptoms. However, young patients with advanced gastric cancer tend to have a favorable general condition and organ function, so they can tolerate intensive systematic chemotherapy. Unfortunately, the prognosis of gastric cancer in young patients with an advanced stage is not favorable. We should not take this rare disease lightly, given its poor prognosis if patients are diagnosed at an unresectable stage. The evaluation of the H. pylori infection status and performance of H. pylori eradication therapy to prevent gastric cancer in young patients as well as the development of more intensive chemotherapy regimens for unre-sectable gastric cancer in young patients are warranted.
胃癌通常发生在中老年患者中，在年轻患者中很少见。由于其发病率较低，年轻患者胃癌的临床特征、病因、预后、预防方法和治疗尚未得到充分研究。在这篇综述中，我们讨论了与年轻患者胃癌相关的现有认识和临床问题。
幽门螺杆菌（H. pylori）是胃癌的主要病因，尤其是在老年人群中，与年轻和老年患者的胃癌密切相关。年轻患者的胃癌往往在出现警报症状时已处于晚期。然而，晚期胃癌的年轻患者一般身体状况和器官功能良好，因此能够耐受强化系统化疗。不幸的是，晚期年轻患者胃癌的预后并不乐观。如果患者在不可切除阶段被诊断出患有这种罕见疾病，其预后较差，我们不应轻视它。评估 H. pylori 感染状况并进行 H. pylori 根除治疗以预防年轻患者胃癌，以及为年轻患者不可切除胃癌开发更强化疗方案是必要的。
