| Object:To reinforce the understand of gastric carcinoma(GC)in young patients and improve the ability of diagnosis of this kind of disease,we retrospectively reviewed the clinicopathological characteristics of GC in young patients.Methods:We searched cases in the Second Affiliated Hospital Of Dalian Medical University over the period between January 2001 and september 2016.Then we identified 206 cases of GC in young patients(≤44 years old)and 4192 cases of GC in elderly patients(>44 years old).Systematic sampling method were used to select 206 cases of GC in elderly patients as the control group.All cases were confirmed by pathology after operation.We compare the young patients and the elderly patients by SPSS22.0statistical software in such following aspects : gender composition,clinical symptoms,tumor site,etc.The result of this paper included the percentage and the media,the related factors were analyzed using the chi square test,p<0.05 with statistical significance.Results:1.General information: youth group were 206 cases,male 106 cases and female 100 cases,male accounting for 51.46%,female accounting for 48.54%,male to female ratio1.06:1,the minimum age 18 years old,the maximum age 44 years old,the average age38.38±5.30 years old,the media age 40 years old,predilection age 36-44 years old,accounting for 74.27%.Elderly group were 206 cases,male 158 cases and female 48 cases,male accounting for 76.7%,female accounting for 23.3%,male to female ratio3.29:1,the minimum age 45 years old,the maximum age 86 years old,the average age63.26±8.97 years old,the media age 62 years old,predilection age 54-62 years old,accounting for 36.41%.2.The comparison on the ratio of male to female between the youth group and the elderly group: youth group(male accounting for 51.46%,female accounting for 48.54%,ratio of male to female is 1.06:1),elderly group(male accounting for 76.7%,female accounting for 23.3%,male to female ratio 3.29:1),the differences between two groups were statistically significant(P<0.05),showed that the Youth group is predominantly female.3.The comparison on the clinical symptoms between the youth group and the elderly group: The comparison aspects include abdominal discomfort(88.8,86.4%),nausea and vomiting(5.3,16.0%),gastrointestinal bleeding(10.7%,10.2%),anemia(42.2%,36.9%),dysphagia(2.4%,6.3%),distant metastasis(2.4%,2.9%),inertia weight loss(0.05%,4.9%).The predominant symptom of GC in young patients is abdominal discomfort.nausea and vomiting along with inertia weight loss in the youth group are less than the elderly group,with statistical significance(P<0.05),showed that these two symptoms of young patients are less happened than elderly patients.4.The comparison on the tumor location and tumor size between the youth group and the elderly group: The tumor location which occupy highest percentage in both youth group(42.7%)and elderly group(47.1%)is pylorus.The tumor size which occupy highest percentage in both youth group(37.4%)and elderly group(31.6%)is the size below 3 centimeter.The difference on tumor location and tumor size between the youth group and the elderly group have no significant statistical significance(P>0.05).5.The comparison on the depth of invasion,lymph node metastasis,distant metastasis, clinical staging between the youth group and the elderly group: depth of invasion along with distant metastasis between two groups have no differences by statistical analysis(P>0.05).N1 ratio(23.3%,39.3%)and Ⅳstage(41.3%,51.0%)in the youth group are less than the elderly group,with statistically difference(P<0.05).6.The comparison on the histopathological typing between the youth group and the elderly group: The percentage of signet cell carcinoma(40.8%)is the highest in the youth group,however in the elderly group is the moderately differentiated adenocarcinoma(44.2%).Poorly differentiated adenocarcinoma and moderately differentiated adenocarcinoma of the youth group(28.2% 、 23.8%)are less than the elderly group(40.3% 、 44.2%),however signet cell carcinoma of the youth group(40.8%)is more than the elderly group(8.3%),with statistically significant differences(P<0.05).7.The comparison on the tumor markers and fibrinogen between the youth group and the elderly group: The highest percentage of the tumor marker is CEA in the youth group(37.9%),however in the elderly group is the feminine of tumor marker(41.3%).CA125 and CA199 of the youth group(32.0% 、 34.0%)are more than the elderly group(21.8% 、 22.3%),however the feminine of the tumor marker of the youth group(31.6%)is less than the elderly group(41.3%),with statistically significant differences(P<0.05).The differences between the youth group and the elderly group of fibrinogen(68.0%、63.1%)have no statistically significance(P>0.05).8.The comparison on the clinical symptoms between male and female in the youth group: The main clinical symptoms of both male and female(48cases,48%)in the youth group is abdominal discomfort.The percentage of anemia in male(29cases,27.4%)is less than female(48cases,48%),with statistically significant differences(P<0.05).9.The comparison on the tumor location and tumor size between male and female in the youth group: The highest percentage about tumor location of both male(46.2%)and female(39%)in the youth group is pylorus.Tumor located in the gastric body in male group were 21 cases and accounting for 19.8%,however in female group were 33 cases and accounting for 33%.This difference between male and female has no statistically significance(P>0.05).10.The comparison on the depth of invasion,lymph node metastasis,distant metastasis,clinical staging between male and female in the youth group: The difference between male and female in the youth on the depth of invasion,lymph node metastasis and clinical staging has no statistical significance(P>0.05).The percentage on distant metastasis of female is 36%,higher than the male(19.8%),with statistically significant difference(P<0.05).11.The comparison on the histopathological typing between male and female in the youth group: The highest percentage of the histopathological typing in male is moderately differentiated adenocarcinoma(36cases,34%)and signet cell carcinoma(36cases,34%).The highest percentage of the histopathological typing in female is signet cell carcinoma(48cases,48%).moderately differentiated adenocarcinoma of the male group(28.2% 、 23.8%)are more than the female group(40.3%、44.2%),however signet cell carcinoma of the female group(40.8%)is more than the male group(8.3%),with statistically significant differences(P<0.05).12.The differences on the tumor markers and fibrinogen between male and female has no statistical significance(P>0.05).13.The comparison on the ratio of male to female between different age grades(18-26 years old,27-35 years old and 36-44 years old): The differences(0.33:1、0.5:1、1.39:1)has significant statistical significance(P<0.05),showed that the amount of female is more than male in 18-26 years old and 27-35 years old,on the contrary,in36-44 years old the amount of male is more than female. 14.The comparison on the clinical symptoms between different age grades(18-26 years old,27-35 years old and 36-44 years old): The main clinical symptoms of three age grades in the youth group is abdominal discomfort,the percentage are 75%、88.9%、89.5% respectively.The differences of comparative between three groups have no significant statistical significance(P>0.05).15.The comparison on the tumor location and tumor size between different age grades(18-26 years old,27-35 years old and 36-44 years old): The difference on tumor size has no significant statistical significance(P>0.05).The percentage of these three groups whose tumor located in the pylorus were 50% 、 48.9% 、 40.5% respectively.The percentage of these three groups whose tumor located in the angle of gastric were12.5%、4.4%、19.6% respectively.The differences of comparative between three groups have significant statistical significance(P<0.05).16.The comparison on the depth of invasion,lymph node metastasis,distant metastasis,clinical staging between different age grades(18-26 years old,27-35 years old and36-44 years old): 27-35 years old group and 36-44 years group old have the highest percentage of N2(35.6%、34.6%),18-26 years old group have the highest percentage of N3(50%).The percentage of N2 and N3 in 18-26 years old group are higher than two other groups,but the differences of comparative have no significant statistical significance(P>0.05).The percentage of distant metastasis of three groups are62.5%,35.6%,23.5% respectively and the differences of comparative between three groups have significant statistical significance(P<0.05).Each group have the highest percentage on Ⅳ clinical staging(50% 、 44.4% 、 39.9%),but the differences of comparative have no significant statistical significance(P>0.05).17.The comparison on the histopathological typing between different age grades(18-26 years old,27-35 years old and 36-44 years old): The highest percentage of the histopathological typing in different age grades is signet cell carcinoma(75%、46.7%、37.3%).18.The comparison on the tumor markers and fibrinogen between different age grades(18-26 years old,27-35 years old and 36-44 years old): The percentage of CEA in27-35 years old group and 36-44 years old group is highest(44.4% 、 34.6%).The percentage of CEA、CA125、CA199 in 18-26 years old group is highest(62.5%).The differences of comparative between different tumor markers have no significant statistical significance(P>0.05).The percentage of fibrinogen which in normal range in every age groups is highest(62.5%、62.2%、69.9%).The differences of comparative between different age grades of fibrinogen have no significant statistical significance(P>0.05).Conclusion:1.The GC in young patients is predominantly female and the predilection age group is36-44 years old.2.The main symptoms of GC in young patients is epigastric discomfort.Nausea and vomiting along with inertia weight loss of GC in young patients are less than the elderly patients.The percentage of CA125 and CA199 of GC in young patients are higher than the elderly patients.The histopathological typing of GC in young patients is predominantly signet cell carcinoma,with a high degree of malignant.3.The incidence of anemia in female of GC in young patients is higher than male.The histopathological typing in female of GC in young patients is predominantly signet cell carcinoma.The incidence of distant metastasis in female of GC in young patients is higher than male.4.The younger in young patients with GC,the more prone to tumor metastasis. |
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