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比较青年人（≤４０岁）大肠癌与中老年人大肠癌临床病理学特征差异对预后的影响。方法从临床病理、细胞增殖状态以及大肠癌相关基因表达等方面，探讨了影响青年人（２３例）与中老年人大肠癌（７１例）预后差异的可能因素。结果青年组五年生存率（３９％）低于中老年组（６５％），Ｌｏｇｒａｎｋ检验两组预后差异显著（Ｐ＝０．０４）。青年组大肠癌中粘液癌所占比例较中老年组高，分别为３５％与１８％；淋巴结转移率（５７％）也高于中老年组（３２％）。ｒａｓ┐ｐ２１蛋白与增殖细胞核抗原（ＰＣＮＡ）表达状态与大肠癌的预后关系不密切。突变型ｐ５３蛋白表达与大肠癌预后显著正相关，但未提示两年龄组大肠癌预后差异与此相关。经多因素Ｃｏｘ回归调整，提示年龄因素可能不是影响大肠癌预后的独立性因素，而与大肠癌预后密切相关的因素是：淋巴结转移、突变型ｐ５３蛋白表达。结论引起两年龄组大肠癌预后差异的原因，可能是由于两组间的临床病理特征不同所致。
Comparison of the clinical pathological features of colorectal cancer and middle-aged and old patients with young persons (≤ 40 years old) on the prognosis. METHODS: Probable factors affecting the prognosis of colorectal cancer (71 cases) in young people (23 cases) and middle-aged and elderly people were explored from the aspects of clinicopathology, cell proliferation and colorectal cancer related gene expression. Results The five-year survival rate in the young group (39%) was lower than that in the middle-aged group (65%). Logrank test showed significant difference between the two groups (P=0.04). The proportion of mucinous carcinoma in colorectal cancer was higher in the youth group than in the middle-aged group (35% and 18%, respectively); the lymph node metastasis rate (57%) was also higher than that in the middle-aged group (32%). The expression of ras┐p21 protein and proliferating cell nuclear antigen (PCNA) is not closely related to the prognosis of colorectal cancer. There was a significant positive correlation between the expression of mutant p53 protein and the prognosis of colorectal cancer, but no correlation between the prognosis of colorectal cancer in two age groups was suggested. After multivariate Cox regression adjustment, suggesting that age factor may not be an independent factor influencing the prognosis of colorectal cancer, the factors closely related to the prognosis of colorectal cancer are: lymph node metastasis and mutant p53 protein expression. Conclusion The cause of the difference in the prognosis of colorectal cancer in two age groups may be due to the difference in clinical pathological characteristics between the two groups.