青年胃癌患者的预后分析

目的探讨青年（≤40岁）胃癌患者的临床特征及预后。方法分析2000年12月至2008年12月本院手术治疗的780例胃癌患者的资料，比较青年胃癌患者与老年（≥70岁）胃癌患者临床病理特征及预后。结果780例胃癌患者中，青年患者76例，占917％。老年患者90例，占11．5％。与老年胃癌患者比较，青年胃癌患者无报警症状比例升高（23．7％vs11．1％，P=O031）；早期胃癌比例升高（26．3％vs8，9％，P=0．003）。青年胃癌患者和老年胃癌患者的5年生存率无明显区别（36．1％vs29．1％，P=0．560）。进一步分析表明，早期胃癌患者中，青年组预后要优于老年组，中位生存期分别为943个月和63．3个月（P=0．023）；进展期胃癌患者中，青年组不如老年组，中位生存期分别为30，9月和41．3个月（P=0．042）。结论与老年胃癌比较，青年胃癌具有“报警症状”少、早期胃癌比例高的特点；青年胃癌预后并不差于老年胃癌，年轻是预后的保护性因素。

Clinical features and prognosis of gastric cancer in young patients

Objective To review the clinical features and the prognosis of gastric cancer in young patients. Methods Clinical data of 780 patients with gastric cancer admitted during December 2000 to December 2008 were retrospectively reviewed. The clinical features and prognosis of young patients were compared with those of elderly ones. Results Among 780 gastric cancer patients, 76 patients （9.7%） were aged ≤40 （young group）, 90 patients （11.5%） were aged over 70 （elderly group）. The ratio of ＂no alarm symptoms＂and early gastric cancer in young group were higher than those in elderly groups （23.7% vs 11.1%, P=0.031 and 26.3% vs 8.9%, P=0,003, respectively）. There was no significant difference in the 5-years survival rates between young patients and elderly patients （36.1% vs 29.1%, P=0.560）. The median survival time（MST）of young patients with early gastric cancer was longer than that of elderly group （94.3 months vs 63.3 months, P=0.023）; on the contrary, the MST of young patients with advanced gastric cancer was shorter than that of elderly patients （30.9 months vs 41.3 months,P=0.042）. Conclusion Young patients with gastric cancer have less ＂alarm symptoms＂and more early gastric cancers with more favorable prognosis than elderly patients.