| Background and Objective: Gastric carcinoma is common malignant tumor in digestive tract.It has high incidence in China and Gansu province. It is considered to be a disease of elderly patients.But in recent years, the incidence of gastric cancer in young people has increased. Previous studies have found that gastric cancer in young patients have its own epidemiological and clinical pathological characteristic. The aim of this study was to analysis the epidemiological and clinical pathological features of young gastric cancer patients via retrospect the medical records of 137 gastric cancer patients aged less than 40 years treated at the First Hospital of Lanzhou University from 2010 to 2015. To provide data for the further study of gastric cancer in young people in the future and to assist in the diagnosis, treatment and evaluation of prognosis of young patients with gastric cancer.Methods: The clinical cases of 2416 gastric cancer patients treated at the First Hospital of Lanzhou University from January 1st 2010 to December 31 st 2015 were collected retrospectively.According to the inclusion criteria and exclusion criteria, the cases of 137 gastric cancer patients aged less than 40 years was eventually selected. To identify the epidemiology and clinical pathological characteristics of the selected cases, we analysed the items including the gender, age,of patients with gastric cancer, esophageal cancer and colon cancer, the young gastric patients’ native place, time of being hospitalized, personal history, family history, past history, occupation,body mass index, KPS score, symptoms and signs, test results of blood and tumor markers, tumor size, depth of invasion, pathological type, lymph node metastasis, distant metastasis, tumor gross type, TNM stage and treatment method. All the clinical data were collected for statistic analysis,Chi-square test, Fisher exact test, Wilcoxon rank sum test, and Kruskal Wallis was applied for count data, Spearman test and Pearson test for correlation tests. Regarding p<0.05 as the inspection level which means differences were statistical significance between the two group, IBM SPSS 19.0 was used for the analysis of all the statistical data.Results: There were 137 cases of young patients in 2416 cases of gastric cancer patients, which accounting for 5.67%, mean aged 35.31±5.18 years old. The mean age of young patients with gastric cancer was statistically different with the patients with esophageal cancer or colon cancer.The trend of the change of young(≤40years), middle-aged, eldly(≥70years) gastric cancer patients in six years was statistically significant. The ratio of male to female was significantly different in that of young and elderly gastric cancer patients. The proportion of women in the youth group increased. The gender ratio among three age groups(≤25years, 26-35 years, 36-40years) was no significant different. All cases of gastric cancer’s proportion of cities in Gansu province was negatively related to the distance away from the capital city of Lanzhou. There were significant differences in body mass index between different gender and age groups. Gastric cancer in young had no specific symptoms. Bellyache was the most frequent symptom, its incidence in female was higher than that in male. The gastric antrum was the most location of gastric cancer in young,followed by the corpora. There were most BorrmannⅢ(81.6%) in gross types of advanced gastric cancer. The pathological classification of adenocarcinoma accounted for 88.6%, poorly differentiated adenocarcinoma was the most common. 75.91% of the patients underwent radical surgery, 79.81% of them underwent neoadjuvant chemotherapy. Treatment of radical surgery was related to tumor size and TNM stage, was no significant correlated with other factors.Conclusions: Gastric adenocarcinomas in young patients aged less than 40 years have unique clinicopathological features: high incidence after 35 years old, higher proportion of female, occult symptoms, strong tolerance with symptoms, more frequence in antrum and corpora, more BorrmannⅢ type, more poorly differentiated adenocarcinoma and signet ring cell cancer, higher proportion of N3 stage, more TNM Ⅲ stage. It still needs large sample prospective studies to identify differences of clinical pathological characteristics and prognosis between young and elderly patients with gastric cancer. To achieve early diagnosis and early treatment.clinicians should fully understand the characteristics of young patients with gastric cancer and do gastroscope examination to them if they had alam symptoms or family history of gastric cancer. |
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