Impact of age on clinicopathological features and survival of patients with noncardia gastric adenocarcinoma.
Impact of age on clinicopathological features and survival of patients with noncardia gastric adenocarcinoma.
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DOI：
10.5230/jgc.2014.14.4.238
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发表时间：
2014-12
影响因子：
2.5
通讯作者：
Li D
中科院分区：
文献类型：
--
作者：
Bautista MC;Jiang SF;Armstrong MA;Postlethwaite D;Li D
胃癌通常发生在老年人，但在年轻人中并不常见。年轻患者的临床行为和结果是否与老年患者不同仍不清楚。我们在2000年至2010年期间从凯撒永久北加州癌症登记中心确认了1366例新诊断的非贲门胃腺癌病例。然后，我们比较了不同年龄组的临床病理特征和生存情况。年轻患者组和老年患者组之间的男性：女性比例有显著差异(50岁时为0.84岁，60岁时为1.52&60岁，P<；0.01)。更年轻的患者是西班牙裔(54%的患者≥70岁，P<；0.0001)，而更多的老年患者是高加索人(49%的患者≥70岁，15%的患者40岁；P<；0.0001)。弥漫/混合组织学类型在年轻患者中更常见(70%的患者≥70岁；P<；0.0001)，而肠型在老年患者中更常见(70岁患者≥70岁患者的71%对40岁患者的30%P<；0.0001)。低分化腺癌在年轻患者中更为常见(40岁以上患者中80%，而70岁≥患者中60%；P=0.016)。随年龄增长，1、2、5年生存率逐渐下降(总体P=0.0002)。与老年患者相比，年轻胃癌患者的疾病侵袭性更强，但总体存活率更高。年轻的西班牙裔患者和年长的高加索患者更有可能被诊断为胃癌。这些差异可能是由于生物易感性和/或环境暴露造成的。
Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear. We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups. The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ≥70 years, P<0.0001), while more older patients were Caucasian (49% patients ≥70 years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ≥70 years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ≥70 years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ≥70 years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002). Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.