青年人与老年人原发性肝癌的临床分析

目的 提高青年人与老年人原发性肝癌的临床诊断和防治水平。方法 自1990年至2002年我院共收治原发性肝癌272例，其中年龄40岁以下32例(青年组)，年龄60岁以上52例(老年组)，比较分析青年人与老年人原发性肝癌的临床特征。结果血 清HBsAg阳性者青年组高于老年组；合并肝硬化者老年组高于青年组。结论 两组肿瘤类型和临床分期存在差异。     

青年人与老年人原发性肝癌的临床分析

目的　提高青年人与老年人原发性肝癌的临床诊断和防治水平。方法　自 1990年至 2 0 0 2年我院共收治原发性肝癌 2 72例 ,其中年龄 40岁以下 3 2例 (青年组 ) ,年龄 60岁以上 5 2例 (老年组 ) ,比较分析青年人与老年人原发性肝癌的临床特征。结果　血清HBsAg阳性者青年组高于老年组 ;合并肝硬化者老年组高于青年组。结论　两组肿瘤类型和临床分期存在差异。     

特殊年龄段肝癌的临床病理特点(附100例报告)

目的分析特殊年龄段肝癌的临床和病理特点.探讨不同的诊治途径和综合对策.方法我科1995年8月至1999年8月收治的原发性肝癌480例,选年龄≤40岁和年龄≥60岁两组(即青年组和老年组),对比分析两年龄段患者HBsAg阳性率、ALT异常(高于正常4倍)、AFP阳性(＞400μg/ml)、肝癌类型、门静脉癌栓、手术切除率及存活率的差异.结果2年龄段有显著性差异结果(P＜0.05)分别是HBsAg阳性率(90%,55%)、ALT异常(88.89%,50%)、AFP阳性(70%,37.50%)、弥漫性肝癌(23.33%,7.50%)、门静脉癌栓(20%,7.50%).而存活率青年组术后存活超过3年3例,老年组有6例超过3年.结论青年人肝癌恶性程度高于老年人;恶性程度与肝炎活动、肿瘤侵润生长有关;对高危青年,应定期检查AFP和B超以获得早期发现和及时治疗;老年肝癌手术切除仍可取得较好疗效.     

青年人与老年人肺癌的比较

目的 对青年人肺癌（年龄≤40岁）和老年人肺癌（年龄≥70岁）的病理类型、临床表现、性别比例、临床分期及对治疗的选择进行比较。方法 回顾性收集6年来在我院经病理学证实青年人组70例及老年人组135例肺癌患者的年龄、性别、组织学分类、起始症状、临床分期及治疗经过进行比较。结果 （1）青年人组中女性患者比例较老年人组明显增高（P＜0.01)。青年人组腺癌的比例亦较老年组高。（2）青年组中出现胸痛症状的比例明显高于老年人组（P＜0.01)。（3）青年人组中中晚、期比例略高于老年人组，但统计学上无显著性差异。（4）青年人组中手术治疗及放化疗的比例要明显高于老年人组（P＜0.01)，老年人组中更倾向于保守治疗。结论 青年人肺癌与老年人肺癌相比，女性患者比例明显增高，腺癌比例增高，疾病进展迅速，恶性度高，且易误诊。早期诊断，积极治疗能提高肺癌的生存期。     

老年人肝癌DNA含量测定及临床病理特点分析

目的 探讨老年人肝癌ＤＮＡ呈及其临床病理特点。方法 将８６５例肝癌患者分为老年组（１９９例）和对照组（６６６例）,分析其临床特点,对５６例切除标本行肝癌细胞ＤＮＡ含量测定并对其病理指标比较性分析,其中老年组１４例,对照组４２例。结果 肝癌细胞ＤＮＡ含量均为异位体分布模式,老年人肝癌ＤＮＡ含量及其他病理指标和对照组差异无显著性。临床上老年人肝癌具有病程长,就诊晚,临床表现不典型,多为右肝中晚期巨大肝     

青年人和老年人大肠癌的比较研究

目的 探讨青年人和老年人大肠癌的临床及病理特征。方法 对147例青年人和老年人大肠癌患者的临床特征者分析,测定患者血清CEA、CA242,采用免疫组化方法测定其p53、c－erbB2和CD44V6蛋白的表达情况。结果 青年组和老年组大肠癌在性别分布上无差异,2组中直肠癌均多于结肠癌（P＞0．05）,而青年组肿瘤细胞多数分化程度差（低－末分）,上组肿瘤细胞分化程度较好（高－中分化）;青年组病程较晚（Duke＇s C＋D）病例的比较老年组高（P＜0．05）;青年组和老年组CEA、CA242、p53、c－erbB2、CD44V6的阳性率分别为34．1％、56．1％、53．7％、56．1％、36．6％和19．8％、23．6％、33．0％37．7％、17．9％,除CEA外,其余4项指标,2组比较均有显著性差异（P＜0．05）。结论 青年人和老年人大肠癌有不同的临床特点及生物学特征。     

老年人肝癌64例分析

为了探讨老年人肝癌的特点及如何改善其预后，我们收集了老年原发性肝癌64例，并与同期非老年组63例对比，结合文献分析讨论如下。材料与方法老年组64例中男52例，女9例，男：女为4．33：1。年龄为60～70岁，平均年龄为62．6岁。非老年组63例，男54例，女9例，男：女为6：1。年龄为19～56岁，平均年龄为41．75岁。两组病例接UICC（国际抗癌协会）原发性肝癌TNM分期标准，全部为T3、T4。根据B超及CT的检查，并按实用内科的诊断标准与分型［1」，老年组结节型20例，巨块型28例，弥漫型12例，其中有慢活肝和（或）肝硬化病史者48例（占73…     

青年人原发性肝癌（附34例分析）

青年人原发性肝癌早期临床表现缺乏特异性，病程短，转移早，加上警惕性不高，临床上容易漏诊和误诊。因此，本文将我院1976-1990年收治的30岁以下青年人原发性肝癌34例加以分析，并探讨其临床特点。     

青年人与老年人直肠癌的临床病理与预后对比

目的探讨青年人与老年人直肠癌的临床病理特征及预后的差异。方法回顾1996年1月至2006年1月可手术的85例青年人（≤40岁）直肠癌与155例老年人（≥65岁）直肠癌患者的临床病理资料和随访资料,进行生存分析和预后多因素分析。结果青年人直肠癌发生在腹膜返折下占69.41％,高于老年组的52．90％（P=0．013）;低分化腺癌及黏液、印戒细胞癌比例分别为31．76％及22．35％,也分别高于老年组的18．71％及8．39％（P=0．023,P=0．007）;青年组有淋巴结转移者为63．53％,高于老年组的47．10％（P=0．015）;青年组与老年组的5生存率分别为48．2％、55．7％,两组差异无统计学意义（P=0．176）;多因素分析结果显示,手术性质、肿瘤侵犯深度、淋巴结转移、TNM分期是影响预后最重要的独立因素。结论与老年患者相比,青年患者直肠癌恶性度较高,发现较晚,但若能及早发现并通过根治手术为主联合放化疗,预后可与老年患者无差异。     

胃癌486例临床病理分析

 目的　探讨胃癌的临床、内窥镜、病理规律，提高早期诊断率，延长术后生存期。方法　通过做胃镜活检、病理检查确诊486例胃癌患者，其中293例患者进行幽门螺杆菌（HP）检测，将胃癌患者分成青年、中年、老年三组，对其临床、内窥镜、病理及术后生存进行比较分析。结果　486例胃癌患者临床表现以上腹痛为主，占82.92 %（403／486）。中、老年组哽噎感分别占同组44.14 %、43.96 % ，高于青年组（P＜0.005）。老年组呕血或便血占同组34.78 %，高于中、青年组（P＜0.05）。青年组以BormannⅢ型为主，占同组43.48 %，高于中、老年组（P＜0.005）。中、老年组以Ⅱ型为主，分别占同组42.58 %、39.13 %，三组比较差异无统计学意义（P＞0.05）。272例贲门癌，中、老年组高于青年组（P＜0.005）；青年组胃窦癌10例（43.48 %），高于中、老年组，差异有统计学意义（P＜0.005）。近十年来胃镜检查发现胃癌患者293例，HP感染阳性172例（58.70 %）。青、中、老年三组差异无统计学意义（P＞0.05）；病理检查青年组低分化型9例，高于中、老年组（P＜0.05）。结论　对青年人出现非特异性消化道症状要提高警惕；对于40岁以上中、老年人出现哽噎感和呕血或便血的临床表现时要及时进行胃镜检查，特别是对贲门部要仔细观察，尤其男性；重视对胃癌高危人群定期胃镜常规检查；建议对高发地区40岁以上中、老年人每年行胃镜体检。     

Breast carcinoma in women age 25 years or less

BACKGROUND: Although several studies have examined breast carcinoma in young women aged < or = 35 years at diagnosis, there are only occasional cases reported in very young women aged < or = 25 years, and, to the authors' knowledge, no series are available. The presentation, tumor biology, behavior, and outcome of breast carcinoma in very young women are not known, and the rarity of breast malignancy within this age group could lead to diagnostic delays. METHODS: The tumor characteristics and survival of 15 women aged < or = 25 years at the time of diagnosis, have been reviewed and compared with women aged 26-35 years under the care of Guy's Hospital's Breast Unit during the same period of time. Where appropriate, the two groups were individually matched for tumor size (clinical measurement) and histologic grade. RESULTS: Fifteen cases were examined, with a median follow-up of 108 months and a median age of 24 years. The median duration of symptoms was 4 weeks, and the median tumor size was 20 mm. Two patients had ductal carcinoma in situ (DCIS) only, while the other 13 patients had invasive carcinomas, none of which were Grade I. A mastectomy was performed on 8 out of 15 patients (53%). Axillary nodal metastases were present in 4 out of 12 patients (33%). Of the 13 cases of invasive disease, 9 out of 13 patients (69%) experienced recurrence and died of breast carcinoma. Median disease free survival for patients with invasive disease was 86 months. There was no difference in overall survival between the patients aged < or = 25 years and those aged 26-35, but taken together young women < or = 35 had a worse prognosis than women between 36 and 65, due to a higher incidence of high grade and estrogen receptor negative tumors. CONCLUSIONS: The current study suggests that among young women with breast carcinoma there is no difference in prognosis between the very young and the young. Despite two thirds of patients being node negative, the high mortality rate indicates a need for an optimal selection of adjuvant therapy among these cases.     

Hepatic resection for hepatocellular carcinoma in Taiwan.

AIMS: We examined the clinical features and outcome of 80 patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection; 32 patients were under 30 years old (younger-HCC), and 48 patients were over 70 years (elderly-HCC).METHODS: Clinical features of 32 cases of younger-HCC (less than 30 years old) and 48 elderly-HCC (over 70 years old) were reviewed between 1986 and 1999. The clinical features, pathological findings and outcome of the younger and elderly HCC patients were summarized for comparison.RESULTS: Of 573 HCC patients who underwent hepatic resection, 32 were younger than 30 years old and 48 older than 70 years. Less hepatitis B infection, higher hepatitis C infection, more liver cirrhosis development, and a higher ICG 15min retention ratio than the younger group. The younger group tended to have a larger tumor size, more major hepatectomy, more operative blood loss during operation, more perioperative blood transfusion, and more recurrence when compared with the elderly-HCC group. The elderly-HCC group had a significantly better disease-free survival rate than the younger-HCC group. The younger-HCC group had a similar overall survival rate to the elderly-HCC group.CONCLUSIONS: These results seem to indicate a possible difference in the HCC carcinogenesis between younger and elderly patients. The overall survival of the younger HCC patients who undergone hepatic resection was as favorable as that of the elderly.     

老年肺癌与中青年肺癌的临床特点分析

目的:探讨分析老年肺癌与中青年肺癌的临床特点,提高对老年肺癌与中青年肺癌的诊断及治疗的认识。方法:回顾性分析年龄≥65岁的80例老年肺癌患者和年龄＜60岁的60例中青年肺癌患者的临床特征、病理类型、分期及治疗方法,比较两组患者的临床指标差异。结果:两组患者临床症状构成情况、病理类型分布、治疗方案比较无显著差异性（P均＞0.05）;老年组患者胸闷发生率明显低于中青年组患者,中青年组腺癌比例明显高于老年组,老年组患者非小细胞肺癌I期-Ⅲa期比例高于中青年组,但Ⅲb期-Ⅳ期的老年组患者的比例低于中青年组,老年组患者小细胞肺癌局限期比例低于中青年组,广泛期比例多于中青年组,上述差异均具有统计学意义（P均＜0.05）;临床分期的不同导致治疗手段的不同,中青年组接受单纯化疗的比例高于老年组,具有统计学意义（P＜0.05）。结论:老年和中青年肺癌患者在临床症状、肺癌类型、临床分期上存在差异,临床治疗方案的选择应适当参考此差异,以选择合理的治疗方案。     

Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma

Periodic checkup by ultrasonography was conducted on patients with chronic liver diseases for early detection of hepatocellular carcinoma. In 19 months, a total of 2004 examinations were performed on a total of 660 cases (179 cases with liver cirrhosis in the compensatory stage, younger than 70 years; 481 cases with chronic hepatitis, aged 40 to 70 years for men and 50 to 70 years for women). Of the 660 cases, 22 HCC cases (3.3%) were detected and finally diagnosed by angiography and/or histologic examination. Four of those cases (18%) had a single nodule smaller than 1 cm in diameter, and 11 cases (50%) had a single nodule smaller than 2 cm. Surgical resection was performed on 12 cases (55%). In comparison with the control group (83 HCC cases not receiving any periodic checkup), the frequency of small liver cancer and the surgical resection rate in the study group were significantly higher. This examination system by periodic ultrasonography checkup of patients with chronic hepatic diseases was effective for early detection and permitted aggressive therapy of hepatocellular carcinoma.     

Clinicopathologic features of hepatocellular carcinoma in young patients

To investigate clinicopathologic characteristics of hepatocellular carcinoma (HCC) in young adults, excised tumors from 21 patients younger than 45 years (young group) were compared with findings in tumors from 204 patients older than 45 (old group). In the young group HCC showed (1) a high incidence of positive hepatitis B virus surface antigen (HBsAg) (young 71.4% versus old 20.1%); (2) relatively well-preserved hepatocellular function (indocyanine green test; young 10.7 +/- 8.8% versus old 20.6 +/- 10.8%); (3) low incidence of histologically verified concomitant cirrhosis (young 52.4% versus old 78.4%); and (4) a more advanced stage of the disease in TNM classification (Stage III; young 52.4% versus old 18.1%). With respect to survival rates achieved by surgery, there was no statistically significant difference between the two groups. Thus, hepatitis B virus may relate to the occurrence of HCC in the young patients. Despite the advanced stage in the young group, survival rate after surgery was comparable with that achieved in the old group. These observations mean that a close periodic surveillance of young adults with a positive HBsAg is required to detect HCC at an early stage. Treatment of patients with HBsAg using interferon or vidarabine and hepatitis B vaccine should be made to convert HBsAg to negative in these individuals.     

肝癌根治性切除术后联合肝动脉化疗栓塞和门静脉化疗对预防复 …

目的 探讨在肝癌根治性切除术后联合肝动脉化疗栓塞（ｈｅｐａｔｉｃ ｃｈｅｍｏｅｍｂｏ－ｌｉｚａｔｉｏｎ,ＨＡＣＥ）和门静脉化疗（ＰＶＣ）对预防术后复发的价值。方法 总结１９９１年８月～１９９５年７月收治符合根治性切除的原发性肝癌患者８１例。其中,术后联合ＨＡＣＥ和ＰＶＣ（Ⅰ组）２３例,单纯ＨＡＣＥ（Ⅱ组）３０例,未做特殊处理（Ⅲ组）２８例。全部患者随访３年以上。将３组进行对比研究。结果 患者术后１     

Vascular endothelial growth factor, matrix metalloproteinases, and cyclooxygenase-2 influence prognosis of uterine cervical cancer in young women

Recent changes in the lifestyle of young women have led to an increase in the rate of uterine cervical cancer. We investigated the clinicopathological characteristics of uterine cervical cancer in young women, and examined the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinases (MMPs) and cyclooxygenase-2 (COX-2). Tumor samples from 439 patients with uterine cervical cancer, who were initially treated at Osaka City University Medical School Hospital, Japan between 1995 and 2004, were stained immunohistochemically. The patients were classified into two groups according to age at onset: group Y included women aged < or =35 years, and group O included women aged > or =36 years. Group Y had more cases of squamous cell carcinoma, while group O had more advanced cases (P<0.05). Advanced cases (beyond stage Ib2) had a significantly worse prognosis in group Y than in group O (P<0.05). There were no differences between the two groups in the expressions of VEGF, MMP-2 and COX-2. However, in advanced cases (beyond stage Ib2), the expression of VEGF, MMP-2 and COX-2 was significantly greater in group Y than in group O (P<0.05). The above findings suggest that the expression of VEGF, MMPs and COX-2 is related to a worse prognosis for advanced uterine cervical cancer in young women.     

年龄≤40岁的乳腺恶性叶状肿瘤患者临床特征及预后影响因素

  目的  探讨年龄≤40岁的乳腺恶性叶状肿瘤（malignant phyllodes tumors,MPTs）患者临床特征及预后因素。  方法  回顾性分析2006年1月至2020年10月188例于天津医科大学肿瘤医院收治的乳腺MPTs患者的临床资料,按照年龄≤40岁和年龄>40岁分为年轻组54例和年长组134例。采用χ2检验或Fisher确切概率法、Kaplan–Meier法、Cox比例风险回归模型进行统计学分析。  结果  年轻组乳腺MPTs患者5年和10年无复发生存（recurrence- free survival, RFS）率分别为55.8%和46.6%。年轻组患者的肿瘤直径>5 cm占59.3%（32/54）、年长组的占35.8%（48/134）,两组比较差异具有统计学意义（P=0.031）;年轻组患者的手术切缘<1 cm和术后化疗的比例分别为50.0%（27/54）和20.4%（11/54）,较年长组的35.8%（48/134）和7.5%（10/134）高（P=0.048,P=0.024）;年轻组中的患者行肿块切除术且保证手术切缘≥1 cm与乳腺全乳切除术相比,RFS差异无统计学意义（P=0.410）。Cox比例风险回归模型多因素分析显示,年龄（P=0.034）和手术切缘（P<0.001）是影响术后RFS的独立预后因素。  结论  年龄和手术切缘影响乳腺MPTs预后,年龄≤40岁患者较>40岁预后更差,对于年龄≤40岁患者在保证手术切缘至少1 cm情况下行肿块切除术可行。      

Prognosis for pedunculated hepatocellular carcinoma.

We retrospectively compared the outcome of 13 patients at our institution and that of 163 reported cases of pedunculated hepatocellular carcinoma (HCC) with that of conventional HCC subdivided by tumor diameter (group A: less than 2 cm; group B: 2-5 cm, group C: more than 5 cm). The survival of patients with pedunculated HCC in the 163 reported cases was no different from that of group B, but less favorable than in group A (p < 0.01) and more favorable than in group C (p < 0.01). Among the 163 patients with pedunculated HCC, the 113 cases of surgically treated patients had higher survival than the 21 patients treated with transcatheter arterial embolization (n = 16) or transcatheter arterial infusion chemotherapy (n = 5) (p < 0.01) and than 29 conservatively treated patients (p < 0.001). A total of 70 patients out of 163 (42%) died within 1 year after diagnosis. Additionally, almost all cases of pedunculated HCC showed histologically moderately or poorly differentiated characteristics according to Edmondson and Stainer's classification or the WHO classification. These results suggest that pedunculated HCC has not a favorable prognosis if appropriate surgical resection has not been performed very early within a few months because of its rapid progressive nature.     

Le cancer du sein de la femme jeune dans le sud tunisien

OBJECTIVE: The objective of this retrospective study was to discuss the epidemioclinical criteria, the therapeutic results and the prognostic factors of breast cancer in young women throughout a comparative study of 72 young patients aged less than 35 years and a second group of older premenopausal patients aged between 36 and 50 years. PATIENTS AND METHODS: We reviewed the epidemioclinical records of all the patients. Non-metastatic and operable patients were treated with surgery (conservative or radical) followed by an adjuvant treatment (chemotherapy, radiotherapy, endocrine therapy) indicated according to the prognostic factors. Locally advanced or metastatic tumors were treated with chemotherapy. Overall survival was calculated according to the Kaplan-Meier method. The comparison of survival curves was performed according to log-rank test.The multivariate analysis was performed according to the Cox model. RESULTS: The mean age was of 31.5 years. T2N1, node positive (N+), high grade (SBRII and III) and endocrine non-responsive tumors were the most frequent. There was no difference with the second group of older patients regarding the risk factors and the clinical criteria but mammography was more sensitive in the second group. The 5 years overall survival of young patients was of 57% and pejorative prognostic factors in univariate analysis were: tumor size, N+ and endocrine non-responsiveness. There were not any significant prognostic factors at the multivariate analysis. Young age less than 35 years was not a prognostic factor influencing overall survival in the totality of patients or in the different sub-groups according to the other prognostic factors. CONCLUSION: Clinical presentation and outcome of breast cancer in our young patients aged under 35 years seems not to be different from that in older patients. The conclusions of the different authors are controversial but the majority has reported more advanced tumors with worse prognostic than those of older patients.