Pathological Features And Prognostic Analysis In Patients With Gastric Cancer In Different Age Groups

Objective To understand the pathological fetures of patients with gastric cancer(GC)in different age groups and explore the factors influencing the prognosis of them.Methods From January 2013 to September 2017,a total of 3932 patients with GC treated in the General Hospital of Ningxia Medical University were selected as study subjects,and they were divided into three groups according to age:young-age group(≦40 years old),middle-age goup(41-59 years old),old-age group(≧60 years old).The fetures like gender,Lauren classification,histological types,the degree of tumor differentiation,tumor location,tumor size,depth of infiltration(stage T),lymph node metastasis(stage N)and distant metastasis(stage M)of all patients with GC were retrospectively analyzed,and their survival outcomes were followed up by telephone,text message and outpatient follow-up.Statistical analysis was performed with the version of SPSS21.0 for Windows.Results 1.The age of all patients ranged from 18 to 93 years old,with mean age of60.51±10.97 years old,peak age for GC was 60-69 years old.There were 176 cases in the young-age group,with mean age of 34.41±3.88 years old.There were 1473cases in the middle-age group,with mean age of 52.13±5.14 years old.There were2283 cases in the middle-age group,with mean age of 67.93±5.98 years old.2.Among all patients with GC,there were 3094 males and 838 females,with male:female 3.69:1.There were 97 males and 79 females in the young-age group,with male:female 1.23:1.There were 1152 males and 321 females in the middle-age group,with male:female 3.58:1.There were 1845 males and 438females in the old-age group,with male:female 4.21:1.The incidence of male with GC in the whole group and all age groups was significantly higher than that of female,but the incidence of female with GC in the young-age group was significantly higher than that in the middle-age group and the old-age group.There was statistical significance in the composition ratio of gender in patients with GC among different age groups(χ~2=64.685,P﹤0.001).3.There were statistical significances in the composition ratio of Lauren classification(χ~2=10.605,P=0.031)、histological types(χ~2=57.971,P=0.000)、the degree of tumor differentiation(χ~2=66.931,P=0.000)、tumor location(χ~2=86.708,P=0.000)、stage N(χ~2=17.401,P=0.008)、stage M(χ~2=23.653,P=0.000)in patients with GC among different age groups.4.There were no statistical significances in the composition ratio of tumor size(χ~2=0.311,P=0.856),stage T(χ~2=7.657,P=0.264)in patients with GC among different age groups.5.The rate of follow-up successfully was about 86.0%,and the rate of follow-up failure was about 14.0%.The overall survival rates of patients with GC in the young-age group,the middle-age group and the old-age group were 64.3%,70.8%and 52.3%,respectively.The overall survival rates of GC patients with certain pathological fetures in the young-age group were worse than that in the middle-age group or the old-age group,such as diffuse infiltration,signet ring cell carcinoma,low differentiation,stage T4,stage N3 and stage M1.6.Univariate analysis showed that histological types,degree of tumor differentiation,tumor location,tumor size,stage T,stage N and stage M were the common factors influencing the prognosis of GC patients,with statistically significant differences(P<0.05).7.Multivariate analysis showed that age(χ~2=23.367,P=0.000),histological types(χ~2=94.575,P=0.032),the degree of tumor differentiation(χ~2=93.969,P=0.000),stage T(χ~2=56.993,P=0.000),stage N(χ~2=68.560,P=0.000)and stage M(χ~2=112.883,P=0.000)were independent risk factors influcing the prognosis of patients with GC.Conclusion 1.Relative to the patients with GC in the middle-to-old-age group,the pathological fetures of patients with GC in the young-age group mainly be poorer histological type,low differentiation and easy to metastasis.2.The overall survival rates of patients with GC in the young-age group were lower than that in the middle-age group but higher than that in the old-age group.3.Age,histological types,the degree of tumor differentiation,depth of infiltration(stage T),lymph node metastasis(stage N)and distant metastasis(stage M)were independent risk factors influcing the prognosis of patients with GC.