Gastric adenocarcinoma in patients 40 years of age or younger
Gastric adenocarcinoma in patients 40 years of age or younger
复制标题
DOI：
10.1016/s0002-9610(96)00223-1
复制
发表时间：
1996-11-01
影响因子：
3
通讯作者：
Stabile, BE
中科院分区：
文献类型：
--
作者：
Theuer, CP;deVirgilio, C;Stabile, BE
背景：胃腺癌被认为是中老年疾病，40岁以下患者的报道较少。本研究的目的是确定诊断为胃腺癌的年轻患者的比例，并比较年轻和老年胃腺癌患者的人口统计学、临床和病理特征。方法：一项回顾性队列研究，使用 1982 年至 1996 年在公立教学医院诊断的所有胃腺癌患者的肿瘤登记记录，对 41 岁以下、种族和种族的患者进行人口统计学、临床和病理比较。结果：203 例胃腺癌病例中，有 30 例 (15%) 是在年龄小于 41 岁的患者中诊断出来的（范围 23 至 40 岁）。男女比例为1：1。年轻患者更有可能是黑人（33% vs 17%，P = 0.04）。年轻和老年患者均出现晚期疾病，每组中近一半出现转移。 29 名年轻患者中有 12 名 (41%) 在没有组织学诊断为胃腺癌的情况下接受了手术，而只有 1 名老年患者 (P < 0.001)。30 名年轻患者中的 1 名 (3%) 在胃切除术后存活 39 个月。 20 名患者死亡，其余 9 名失访，全部患有已知的残留或复发性疾病，年轻患者 (23%) 的 6 个月生存率低于老年患者 (42%) (P = 0.14)。年轻患者更有可能出现弥漫性组织学变化（80% vs 55%，P = 0.12）。两组中明显的幽门螺杆菌感染并不常见。结论：在我们公立教学医院诊断的胃腺癌患者中，年轻患者所占比例异常高。年轻患者明显更有可能是黑人，并且不太可能在术前获得准确的组织学诊断。年轻和老年患者均表现为晚期疾病，且生存率较差。年轻患者更可能具有弥漫性组织学，并且 6 个月生存率较差，表明该组中打鼾疾病具有侵袭性。 (C) 1996 年，Excerpta Medica, Inc.
BACKGROUND: Gastric adenocarcinoma is considered a disease of the middle aged and elderly and has been infrequently reported in patients under 40 years of age. The purpose of this study was to determine the proportion of young patients diagnosed with gastric adenocarcinoma and to compare the demographic, clinical and pathologic features of younger and older patients with gastric adenocarcinoma.METHODS: A retrospective cohort study using tumor registry records of all patients' with gastric adenocarcinoma diagnosed from 1982 through 1996 at a public teaching hospital, Demographic, clinical, and pathologic comparisons were made between patients younger than 41 years of age and race- and sex-matched older patients with gastric adenocarcinoma.RESULTS: Thirty of 203 (15%) cases of gastric adenocarcinoma were diagnosed in patients less than 41 years (range 23 to 40). Male to female ratio was 1:1. Young patients were more likely to be black (33% versus 17%, P = 0.04). Both younger and older patients presented with advanced disease, with nearly half of each group having metastases. Twelve of 29 (41%) younger patients were operated on without a histologic diagnosis of gastric adenocarcinoma in contrast to only 1 older patient (P < 0.001), One of 30 (3%) young patients is alive 39 months following gastrectomy. Twenty patients died and the remaining 9 were lost to follow-up, all with known residual or recurrent disease, Six-month survival of young patients (23%) was less than older patients (42%) (P = 0.14). Young patients were more likely to have diffuse histology (80% versus 55%, P = 0.12). Overt infection with Helicobacter pylori was uncommon in both groups,CONCLUSIONS: Young patients accounted for an unusually high proportion of patients with gastric adenocarcinoma diagnosed at our public teaching hospital. Young patients were significantly more likely to be black and less likely to have an accurate preoperative histologic diagnosis. Both young and older patients presented with advanced disease and had poor survival, Young patients were more likely to have diffuse histology and had poorer 6-month survival, suggesting a snore aggressive variety of the disease in this group. (C) 1996 by Excerpta Medica, Inc.