青年胃癌患者临床病理资料的回顾性分析

目的:分析青年胃癌患者临床病理特点与预后之间的关系。方法:分析2007年1月至2009年6月本院手术治疗的653例胃癌患者资料，比较青年胃癌患者与老年胃癌患者临床病理特征及预后。结果:两组相比，青年组胃癌患者以女性多见，易累及全胃，Borrmann Ⅲ、Ⅳ型和印戒细胞癌的比例更高，分化程度更低，浸润程度更深，易出现腹痛，具有遗传因素(P<0.05)。青年组和老年组胃癌患者术后5年生存率分别为39.1％和56.6％，差异有统计学意义(P<0.05)。单因素和多因素预后分析显示，TNM分期和手术方式是影响青年胃癌患者预后的独立因素。结论:青年胃癌以高度恶性弥漫性为主，与遗传关系密切，易误诊漏诊，确诊时多为进展期，故应注重其早期筛查，早期诊断、根治性手术及相关治疗是提高其预后的关键。

Clinicopathological features and prognosis of young patients with gastric cancer

Objective:To summarize the clinicopathological characteristics and analyze the prognostic factors of young patients with gastric cancer.Methods:Clinical data of 653 patients with gastric cancer admitted during January 2007 to June 2009 were retrospectively reviewed.The clinical features and prognosis of young patients were compared with elderly ones.Results:There were statistically significant differences in gender，tumor location，Borrmann type，histological type，differentiated histology，depth of invasion，abdominal pain，heredity between young patients and elder ones(P<0.05)．The 5-year survival rates in young and elder patients were 39.1％ and 56.6％respectively,and the difference was statistically significant（P<0.05).Univariate and multivariate analyses showed that TNM stage and surgical methods were independent predictive factors of survival for young patients．Conclusion:The hereditary effect is significant in the young gastric carcinoma patients,most of which are poorly differentiated.Most patients are in advanced phase and have a poor prognosis because of the high rate of misdiagnosis and missed diagnosis.Radical resection appears to confer the only chance of prolonged survival．