青年胃癌患者的临床特点分析

摘要

目的分析青年胃癌患者的临床、内镜及病理特征，探讨青年胃癌的发病特点。方法回顾性分析2005年4月～2016年4月于我院胃镜及病理诊断胃癌患者共650例资料。对青年（≤40岁，n＝46）与老年（≥60岁，n＝412）胃癌患者的临床资料进行分析，包括性别、年龄、BMI、个人史、家族史、临床症状、病变部位、胃镜下大体类型、组织学分化程度及TNM分期。结果与老年胃癌相比，青年胃癌中女性比例明显增高[47．8％（22／46） vs．29．1％（120／412），χ2＝6．764， P＝0.009]，胃癌肿瘤家族史明显增多[13．0％（6／46） vs．3．2％（13／412），χ2＝7．840， P＝0．005]，肿瘤更多位于远端胃[胃窦60．9％（28／46） vs．36．9％（152／412），χ2＝9．972， P＝0．002]。内镜下大体分型上，青年胃癌Borrmann Ⅳ型比例明显增高[37．0％（17／46） vs．19．2％（79／412），χ2＝7．898， P＝0．005]；病理组织学分化程度上，青年胃癌大多分化程度低[87．0％（40／46） vs．49．3％（203／412），χ2＝23．594， P＝0．000]；肿瘤临床分期上，青年人胃癌患者Ⅳ期比例明显增高[41．3％（19／46） vs．25．5％（105／412），χ2＝5．245， P＝0．022]。结论青年人胃癌中女性比例相对较高，有胃癌家族史更多，恶性程度更高，预后相对较差。%Objective To analyze the clinical characteristics , endoscopic feature and pathological findings of young patients with gastric cancer and to explore the characteristics of gastric cancer in young patients . Methods A total of 650 patients with gastric cancer diagnosed by endoscopy and pathology from April 2005 to April 2016 in our hospital were restrospectively analyzed .The data of young patients (≤40 years old, n =46) and elderly patients (≥60 years old, n =412) were compared.The statistical analysis were conducted to evaluate gender , age, BMI, personal history, family history, clinical symptoms, tumor location, gross type, histologic differentiation degree and TNM stages . Results As compared to the elderly group , the young group had significantly higher female ratio [47.8%(22/46) vs.29.1%(120/412),χ2 =6.764, P=0.009], significantly higher family history of gastric cancer [13.0%(6/46) vs.3.2%(13/412), χ2 =7.840, P=0.005], and more tumors located at the distal stomach [antrum:60.9%(28/46) vs.36.9%(152/412),χ2 =9.972, P=0.002].In the endoscopic gross type, the young group had significantly higher Borrmann Ⅳgastric cancer [37.0%(17/46) vs.19.2%(79/412),χ2 =7.898, P=0.005], worse differentiated histology [87.0%(40/46) vs.49.3%(203/412),χ2 =23.594, P=0.000], and significantly higher stage Ⅳcases [41.3%(19/46) vs. 25.5%(105/412),χ2 =5.245, P=0.022]. Conclusion The young patients with gastric cancer have relatively higher female ratio, more family history of gastric cancer , worse differentiated histology , and relatively poor prognosis .