老年人胃癌的临床分析

目的探讨老年胃癌患者的临床表现、手术及预后特点。方法将我院干部病房收治的209例胃癌患者分为老年组（≥65岁）与非老年组（〈65岁），对比两组的临床资料。结果老年组胃癌占63．2％，无症状者明显多于非老年组（23．5％比16．9％，P〈0．05）。老年组伴随病多于非老年组（81．8％比64．9％，P〈0．05）。两组手术切除率（90．9％比97．4%、根治性切除率为（73．5％比89．6%）、围手术期并发症率（14．4％比7．8％）、围手术期死亡率（3．0％比0％）有明显差异（P〈0．05），5年生存率差异无统计学意义（59．7％比61．1％，P〉0．05）。多因素分析TNM分期和手术根治度是独立的预后影响因素（P〈0．05）。结论老年胃癌中无症状患者多见，伴随病多见，手术风险较非老年组大；老年胃癌预后与非老年患者无明显差别，其预后与TNM分期和手术根治度有关。

Clinical analysis of senile patients with gastric cancer

Objective To study the clinical manifestations, operation, and prognosis of senile patients with gastric cancer. Methods A total of 209 patients with gastric cancer admitted to our department were divided into senile group（≥ 65 years） and non-senile group, and their clinical data were analyzed and compared. Results Gastric cancer was diagnosed in 63.2% of the patients. The percentage of asymptomatic patients was significantly higher in senile group than in non-senile group（23.5% vs 16.9%, P〈0.05）. The percentage of coexistent diseases was significantly higher in senile group than in non-senile group（81.8% vs 64.9%, P〈0.05）. The surgical resection rate, radical resection rate, perioperative complication rate and mortality were 90.9%, 73.5%, 14.4% and 3.0% in senile group, and 97.4%, 89.6%,7.8% and 0% in non-senile group（P〈0.05）. No significant difference was observed in 5-year survival rate between the two groups （59.7% vs 61.1%, P〉0.05）. Multivariate analysis showed that TNM stage and radical surgery degree were the independent factors for the prognosis of gastric cancer patients（P〈0.05）. Conclusion Asymptomatic gastric cancer and coexistent diseases are commonly found in senile gastric cancer patients. The operation risk is greater in senile gastric cancer patients than in non-senile gastric cancer patients. There is no significant difference in prognosis between senile and non-senile gastric cancer patients. TNM stage and radical surgery degree are related with the prognosis of gastric cancer patients.