| Objective:Through comparative analysis of the clinical characteristics and pathological features of colorectal cancer between young (≤40years) and elderly (≥60years) patients, To explore the disease pattern and clinical features of colorectal cancer in young patients. And improve the knowledge of the diagnosis and treatment in colorectal cancer in young patients.Methods:184 cases of colorectal cancer patients aged 40 years and younger in First Affiliated Hospital of KunMing Medical University from April 2013 to September 2015 were retrospectively reviews and compared with 205 patients aged 60 and older 60 years with colorectal cancer.All of them had received colonoscopy and pathologically confirmed.The general informations (gender,age,family history of CRC,laboratory tests, the first symptom and clinicopathological features (including location of tumor.macroscopic type.histological grade,histological type.T stage,N stage,M stage,TNM stage.surgical procedure) were analyzed with x2 Test in two groups.Results:1. The average age of young patients was (35.28±6.89) years old; the median age was 37 years old.2.Generation aspect:the proportion of the young group is 1.02:1, which is lower than the proportion of the old group about 1.28:1, but the difference was not statistically significant.3.Family history of CRC aspect:there are 3 young patients with familial adenomatous polyposis (1.63%),and 14 young patients with family history of CRC. Young patients may have more chance in family history of CRC comparing to old patients.4. First symptom aspect:hematochezia/mucous bloody stools (58.15%)and abdominal pain and abdominal distention(45.11%)are the most common symptom in the young group.The incidence rate of abdominal pain and distention are significantly higher than the old group, while the incidence rate of the change of bowel habit in the young group is lower than the old group. The difference was statistically significant.5.Physical examination:the young group rectal touch was abnormal rate and positive abdominal palpation tenderness were significantly higher than the older group,The difference was statistically significant.6.Laboratory tests: Youth group of anemia was higher than the elderly group,but The difference was not statistically significant,Tumor markers:there is no significant difference among the two groups.7.Colonoscopy:the youth group colonoscopy colorectal polyps combined (26.09%) was significantly lower than that in elderly patients (40.98%),The difference was statistically significant.while colonoscopy young patients who see luminal stenosis (49.46%) higher than older patients (43.90%), but the difference was not statistically significant.8.Disease site aspect:the young patients are mainly Rectum cancer (54.35%) and the incidence of descending colon cancer is significantly higher than the old group.while the incidence of sigmoid cancer colon cancer is significantly lower than the old group,The difference was statistically significant.9.Tumor macroscopic type aspect:both two groups are protruded and ulcerative based, but the youth group protruded, invasive of colorectal cancer incidence was significantly higher in elderly group, while the ulcer was significantly lower than the older group,the difference was statistically significant.10.Histological type and histological grade aspect:the proportion of mucinous/signet-ring adenocarcinoma and poorly differentiated proportion of mucinous/signet-ring adenocarcinoma and middle-poorly differentiated in young patients is significantly higher than old patients.But the proportion of middle differentiated adenocarcinoma in young patients is significantly lower than old patients,the difference was statistically significant.11.Pathology TMN aspect:the proportion of T4 stage in young patients is significantly higher than old patients, while the proportion of T2 stage is significantly lower than old patients.the difference was statistically significant.The proportion of NO stage is significantly lower than old patients,The difference was statistically significant. The young patients are mainly in Ⅲand Ⅳstage. The old patients are mainly in Ⅱ and III stage.The proportion of young patients in III and IVstage is significantly higher than old patients,the difference was statistically significant.12.Therapy aspect:the proportion of palliative surgery in young patients is higher than old patients,the difference was statistically significant.Conclusions:1.The young patients are mainly rectum cancer.lt is important to take rectal touch and tumor marker detection among young people who with hematochezia/mucous bloody stools and abdominal pain and abdominal distention symptom. At the same time, colonoscopy should be conducted as early as possible in order to diagnose accurately and treat timely.2.Young patients with colorectal cancer has a worse histological differentiation,higher malignant degree, The young patients are mainly in Ⅲand IV stage.3.The characteristics of elderly patients with colorectal cancer include a higher proportion of sigmoid and rectum cancer, are mainly in II and III stage and a higher incidence of concomitant colorectal polyps. Total colonoscopy should be emphasized in the diagnosis of colorectal cancer and more active surgical treatment should be adopted in elderly patients. |
