| IntroductionGastric carcinoma is one of the major leading causes of cancer deaths worldwide. In many populations, however, there has been a dramatic decrease in its occurrence, though incidence varies significantly from country to country and within subpopulations. The poor prognosis of gastric cancer can be attributed to late presentation and diagnosis. Hence, early diagnosis of gastric cancer in young would enable improved prognosis and limit the evolution of disease. The aim of this study was to evaluate the clinical characters of gastric carcinoma in young Chinese population aged younger than 40 years.MethodsA retrospective study analysis was conducted at the Gastroenterology department of Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China for a period of 1 year from July 2009 to June 2010.A total of 130 patients younger than 40 years identified as consecutive gastric cancer cases from 2002 till 2009 and managed at the department were recruited. All participants were confirmed cases of malignancy and data was obtained from the clinical history files of the record room. Demographic details were included along with significant clinical information about carcinoma like preexisting benign gastric conditions, initial symptoms at diagnosis, radiological image examination, pathology, tumor marker, lymphatic invasion and metastasis stage. All the data was analyzed by using SPSS version 18, and a P-value of 0.05 was considered significant.ResultsOur study clearly reflected that majority of the cases had multifactorial etiology for gastric cancers. The incidence of gastric cancer was not predominantly involved to Helicobacter pylori, suggesting that environmental factor, diet or a genetic predisposition is becoming important risk factors for gastric cancer among the younger people in China.34.6% of our study participants had invasive carcinoma, and it was predominantly present at the gastric antrum. Most of the symptoms occurred during the middle age and affected both genders equally. Malena was strongly associated to women than men (P<0.01; 95% C.I., 15.047-16.962), and came out to be statistically significant. Also, our study ruled out that there was greater incidence of gastric malignancies among female gender (P<0.001). Immunohistochemical analysis showed that the minimum detectable concentration was slightly higher for CA 125 than for the other assays.Discussions and ConclusionsThe question of whether age at acquisition of H. pylori infection has a bearing on the association with gastric cancer or ulcer disease is important in understanding the pathophysiology of disease process. A transmissible agent may not be significant in those cases and environmental factors or diet is becoming important risk factors as concluded by our study. Most stomach cancers (88%) are adenocarcinomas which may be further classified into poorly to moderately differentiated. The most common histological type ruled out in our study was poorly differentiated adenocarcinoma (68%). This and the signet ring cell cancers (26%) are the forms most closely corresponding to Lauren's diffuse type. The differentiated and tubular cancers resembling the intestinal tumors comprised 11%, while a few tumors could not be classified by Lauren's criteria. The adenocarcinomas are associated with a history of atrophic gastritis and are generally found in patient's age range between 25 to 35years. |
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