青年人胃癌临床病理特点及预后分析  

Clinicopathologic features and prognosis of gastric cancer in young adults

作　　者：鲁翀[1] 王振宁[1] 孙哲[1] 徐惠绵[1] 

机构地区：[1]中国医科大学附属第一医院胃肠肿瘤外科,沈阳110001

出　　处：《中华外科杂志》2008年第19期1468-1471,共4页Chinese Journal of Surgery

摘　　要：目的探讨青年人胃癌不同于中老年人胃癌的临床病理特点及预后相关因素。方法对1980年1月至2000年12月收治的157例青年（≤40岁）与1761例中老年（〉40岁）胃癌患者的临床病理资料进行对比分析。结果组织分化不良、弥漫型生长方式、Borrmann4型及病变累及全胃者在青年组中均明显高于中老年组（P〈0．05），在青年女性组中比例更高。早期胃癌比例在青年组中亦明显高于中老年组（P〈0．05），在青年男性组更高。青年男性组中位生存时间为35个月，青年女性组中位生存时间为19个月，两组生存曲线比较差异有统计学意义（P=0．0219）；中老年男性组中位生存时间为26个月，中老年女性组中位生存时间为30个月，两组差异无统计学意义（P=0．9958）。TNM分期、根治度、大体分型是青年人胃癌预后的独立风险因素。结论与中老年组相比，青年女性胃癌分化差、病期晚者比例较高，总体预后相对较差；而青年男性胃癌早期比例较高，总体预后相对较好。在各种临床病理因素中，病理分期、能否手术切除及手术根治程度是决定青年人胃癌预后的独立因素。Objective To analyze the clinicopathologic features and prognosis of young patients with gastric cancer by comparing with older patients. Method The clinicopathologic data of 157 younger adults （age, ≤40 years） with gastric cancer and 1761 cases of eider gastric cancer patients （age, 〉 40 years） was analyzed and compared retrospectively. All of the 1918 patients were surgically treated between January 1980 and December 2000. Results The rates of poorly differentiation, diffusive growth, Borrmann 4 type, whole-stomach invasion were significantly higher in younger cases than those in the elder counterparts （ P 〈 0.05）, especially in young female patients. The rate of early gastric cancer was significantly higher in young patients than that in older patients （P 〈 0. 05 ）, especially in young male patients. There was significant difference between the survival rate of younger male cases （ median survival, 35 months） and younger female cases （median survival, 19 months） （P = 0. 0219）, but no significant difference was found between elder male and elder female（median survival, 26 vs. 30 months）. TNM stage, operative curability, gross type were independent predictive factors of survival for younger patients. Conclusions Younger female gastric cancer patients tends to have worse prognosis than older patients, while younger male patients have better prognosis due to higher percentage of early gastric cancer when diagnosed. Pathologic staging and operative curability are the independent predictive factors of survival for younger patients.

关 键 词：胃肿瘤 病理学 临床 预后 青年人 

分 类 号：R686[医药卫生—骨科学]