青年胃癌53例临床病理特征与预后分析  

Clinicopathologic Features and Prognosis of Gastric Cancer in 53 Young Adults

作　　者：邢艳敏[1] 谢广茹[1] 潘战宇[1] 孙海燕[1] 刘东颖[1] 

机构地区：[1]天津市肿瘤防治重点实验室,天津医科大学附属肿瘤医院中西医结合治疗科,天津市300060

出　　处：《中国肿瘤临床》2011年第2期97-99,103,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:分析青年胃癌患者的临床病理特征,探讨影响预后的因素。方法:回顾性分析天津医科大学附属肿瘤医院2000年1月～2006年12月间行胃癌手术治疗的年龄≤35岁的青年患者53例的临床资料。结果:青年人胃癌临床表现以上腹部疼痛不适最常见,占77.4%,男女之比为1:1.65,肿瘤部位以胃窦部常见。病理分类弥漫型癌占81.1%,TNM分期Ⅲ～Ⅳ期病例占83%;84.9%原发灶穿透浆膜(T_(3-4));77.4%患者伴淋巴结转移(N_(1-3));32.1%伴有远处转移(M_1)。全组根治手术率64.2%。术后1、3和5年生存率分别为54.7%、22.6%和18.3%。多因素分析显示:TNM分期、手术性质、术后辅助化疗是影响预后的独立因素。结论:青年胃癌以女性和弥漫型癌所占比例较高,临床分期晚,根治性手术切除率低。TNM分期、手术性质及术后辅助化疗是评价其预后的重要参考因素。Objective： To analyze the clinicopathologic features and the prognostic factors of gastric cancer in young adults. Methods： A retrospective study was peiformed using the clinical data of 53 patients aged 35 years or younger with all stages of gastric cancer who underwent surgery in our hospital between 2000 to 2006. Results： Of the 53 cases, the median age was 33 years （range： 25 - 35 years）, and the most common symptoms were abdominal pain and discomfort, reported by 77.4 %. The ratio of male to female was 1：1.65, and tumors were mostly found in the gastric antrum. Diffuse-type carcinomas based on Lauren classification accounted for 81.1%. According to TNM classification, 83% of all cases were stage III-IV, the rate of serosal involvement （ T3-4 ） was 84.9 %, nodal metastases （ N1-3 ） occurred in 77.4%, and distant metastases （ M1 ） occurred in 32.1%. The curative resection rate of the group was only 64.2%. The overall 1-, 3- and 5-year postoperative survival rates were 54.7 %, 22.6 % and 18.3 %, respectively, with an average survival time of 29.79 months. Multivariate analysis indicated that stage, curative resection and postoperative chemotherapy were independent prognostic factors. Conclusions： In young patients with gastric cancer, the predominance of female cases and Lauren diffuse-type carcinomas were distinctive characteristics. In young patients, the clinical stage is usually more advanced at presentation and the rate of successful radical resection is lower. Stage, curative resection and postoperative chemotherapy are important prognostic factors in young patients with gastric cancer.

关 键 词：胃肿瘤 青年 临床病理特征 预后 

分 类 号：R739.63[医药卫生—肿瘤]