Clinical Comparative Analysis Of Young And Old Patients With Colorectal Cancer

PURPOSE: Objective to investigate the clinical features of young colorectal cancer and elderly colorectal cancer,and to improve the diagnosis rate of colorectal cancer in young people.MATERIALS AND METHODS: A retrospective analysis from January 2013 to December 2016 in the First Affiliated Hospital of Fujian Medical University Department of gastrointestinal surgery,through abdominal CT and abdominal MRI,barium enema and colonoscopy examination,and confirmed by surgery and pathology of patients with colorectal cancer in 625 cases,including youth(age < 40)of patients with colorectal cancer in 60 cases,the elderly(aged >65 years)of patients with colorectal cancer in 240 cases,random sampling of 60 cases of colorectal cancer in elder were compared to the youth of patients with colorectal cancer.RESULTS: 1.Gender composition: young group compared with the elderly group there was no statistically significant difference(P > 0.05),but both young and elderly group,the proportion of men are higher than women.2.Family history and misdiagnosis: young group with family history accounted for 5.6%,the misdiagnosis rate was 26.7%,compared with the elderly group,the difference was statistically significant(P<0.05).3.The first symptoms: both young and elderly group with abdominal pain,hematochezia and bowel habits or traits change is given priority to,the incidence of abdominal pain in youth group accounted for 48.3%,compared with the old age group had significant difference(P<0.05).4.Tumor index: young and elderly group there was no statistically significant difference compared with CEA,CA125,CA199(P > 0.05).5 The location of tumor: the young and old patients were mainly in the rectum and sigmoid colon,which accounted for 68.4% and 66.7%,respectively.6.Pathology classification: the incidence rate of poorly differentiated carcinoma and mucous adenocarcinoma and signet ring cell carcinoma was higher than the elderly group compared with the young group.And there was a significant difference between poorly differentiated carcinoma and mucinous adenocarcinoma(P<0.05);The incidence rate of Well differentiated carcinoma and tubular adenocarcinoma is higher than the young group compared with the elderly group,the difference was statistically significant(P<0.05);7 Nerve invasion,lymph node metastasis and TNM stage: the nerve invasion and lymph node metastasis of young group were higher than the elderly group,the difference was statistically significant(P<0.05);the elderly group with stage II tumors were higher than the young group,the difference was statistically significant(P<0.05).However,The proportion of stage III–IV tumors was significantly higher in the young adult group(70%)than in the older group(46.7%).8 Treatment and postoperative complications: there was no significant difference between the young group and the old group in the treatment of the two groups(P>0.05).The young group of postoperative complications(including pulmonary infection,wound infection,anastomotic fistula,urinary tract infection,infection of central venous catheter)accounted for 15%,the elderly group the incidence of postoperative complications accounted for 33.3%,there was significant difference between two groups(P<0.05).CONCLUSION: The incidence of colorectal cancer of male patients is higher in both the young and the elderly,but the clinical symptoms of young patients are not typical,the main is abdominal pain and bloody stool symptoms,the misdiagnosis rate and lymph node metastasis rate and the incidence of nerve invasion is high,low differentiation and high malignant degree,the clinical stage was mainly III and IV,but they have low incidence of postoperative complications,postoperative recovery fast and good adherence.