46例青年胃癌诊疗分析

摘要

Objective To review the clinical features and prognosis of gastric cancer in young patients.Methods The clinical data of 46 young patients with gastric cancer were retrospectively reviewed.Chi square test was used to compare the clinical and pathological characteristics of the patients.The survival rate and median survival time were analyzed by Kaplan-Meier survival analysis.The prognostic factors were analyzed by regression and multivariate analysis (Cox).Results There were no significant differences in tumor location,pathologic type,TNM stage and survival rate of young patients with gastric cancer with regard to sex.Cox regression analysis showed that histological type,TNM stage,tumor size,depth of invasion and lymph node metastasis were related to the prognosis of patients.Lymph node size,tumor location and gender were not associated with prognosis.Conclusions The gastric cancer in young patients normally occurs in the distal end of the stomach such as gastric antrum and gastric angle.The Borrmann Ⅲ type was the main type.The proportion of women in young gastric cancer is higher.The proportion of young patients with poorly differentiated adenocarcinoma is high,and the overall survival rate was not high.%目的 探讨青年胃癌的病理及预后特点,提高青年胃癌病人的诊疗水平.方法 回顾性分析近10年来在南通大学附属江阴医院行胃癌根治术(D2)的46例青年胃癌病人的临床资料、病理资料及预后情况,用χ2检验比较病人的临床病理特征,用Kaplan-Meier生存分析统计生存率及中位生存时间,用Cox回归多因素分析预后因素. 结果 不同性别的青年胃癌在肿瘤部位、分型、TNM分期、生存率等方面差异均无统计学意义,Cox回归分析提示组织学类型、TNM分期、肿瘤大小、浸润深度及淋巴结转移与病人预后相关,淋巴结大小、肿瘤部位及性别与预后无关.结论 青年胃癌好发于胃窦胃角等远端,以Borrmann III型为主,女性在青年胃癌中比例较高,青年胃癌低分化腺癌比例较高,总体生存率不高.