Clinical Analysis Of Gastric Carcinoma In Young Patients

Objective To analyze the clinicopathologic characteristics and prognosis of young patients (less than 35 years of age) with gastric carcinoma and to further improve the level of diagnosis and treatment of gastric carcinoma in young patients. Methods During the period 1996 to 2000 ,the clinical findings of 55 cases young patients (less than 35 years of age) with gastric carcinoma were reviewed retrospectively ,which were compared with those of 62 cases (age >35 years) who had complete follow-up data. To analyze the difference of clinicopathologic features and prognosis between two group. Theχ2was used to evaluate the statistical significance of differences, the survival rates of the patients were calculated using the Kaplan-Meier method and the relative prognostic importance of the parameters was investigated using the Cox proportional hazards model,Log-rank test was used to evaluated the survival rate test,and P values less than 0.05 were considered statistically significant.Results (1) During the period 1996 to 2000 , the rate of young patients with gastric carcinoma was increased, female was more common than male. (2) Clinical features: in young group the most common presenting symptom was hemorrhage (34.54%), tumor size was more than 4cm,early diagnosis rate was low, stage was always late,metastasis was fast,curative resection rate was 56.36%; with regard to the rate of depth invasion T4 was 63.64% in young group which was higher than 20.97% in the control group ( P <0.001); nodle involvement was 86.45% and stageⅣwas more common .The main method of diagnosis was by gastroscopy and upper gastrointestinal series. (3) Pathologic features: Borrmann typeⅢ(32/55,58.18%) lesions were more common in the young group, more young patients had a poor differentiated histology (51/55,92.7%). (4) Prognosis: the 5-year survival rate of the young patients and the control group differed statistically(21.8% vs 48.4%, P <0.05). (5) Univariate analysis showed tumor size,Borrmann type,depth of invasion,operative type,histologic type,tumor stage,lymph nodal involvment,metastasis were related with prognostic factors in the young group.Multivariate analysis showed that the tumor stage,oprative type were significant prognostic factors ,age itself was not an independent pronostic factor. Conclusions (1) In my hospital the rate of young patients with gastric carcinoma was increased,famale was more common than male. (2) In young group tumor size was more than 4cm,early diagnosis rate was low, stage was always late,metastasis was fast,curative resection rate was low. (3) Young patients with gastric carcinoma had a worse prognosis. (4) The tumor stage,oprative type were significant prognostic factors.