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胃癌虽多见于40岁以上患者,但青年人亦非少见,常因缺乏警惕致延误诊断而影响预后,本文对青年人胃癌42例进行分析,以期引起临床的重视。1 临床资料 自1987～1992年经手术或X线、胃镜检查确诊胃癌937例,其中青年人胃癌42例,占4.5％。男性20例,女性22例;年龄最小者16岁,小于20岁5例,21～25岁8例,26～30岁12例,31～35岁17例。(1)病程:初发症状到入院,6个月以内者15例(36％),7个月～1年15例(36％),1～2年7例(16％),2年以上5例(12％)。(2)临床表现:上腹痛38例,呕血或黑便28例,食欲减退25例,全身乏力22例,消瘦21例,呕吐20例,上腹肿块8例,贫血2例,颈部肿块1例。(3)病理检查:以胃窦部最多34例(80.9％),胃体部3例,胃底部1例,全胃者4例。其中低分化腺癌23例,腺癌8例,粘液腺癌6例,未分化癌5例。(4)治疗:36例行手术,其中姑息切除术12例,根治术13例,单纯胃空肠吻合术5例,剖腹探查术6例,其余因极度恶液质或远处转移而未予手术。
Although gastric cancer is more common in patients over the age of 40, but young people are not uncommon, often due to delay in the diagnosis due to lack of alert and affect the prognosis. This article analyzes 42 cases of gastric cancer in young people in order to cause clinical attention. 1 clinical data from 1987 to 1992 by surgery or X-ray, gastroscopy confirmed 937 cases of gastric cancer, including 42 cases of young people with gastric cancer, accounting for 4.5%. There were 20 males and 22 females; the youngest were 16 years old, 5 were younger than 20 years old, 8 were 21 to 25 years old, 12 were 26 to 30 years old, and 17 were 31 to 35 years old. (1) Course of disease: Initial symptoms were admitted to hospital, 15 cases (36%) within 6 months, 15 cases (36%) from 7 months to 1 year, 7 cases (16%) from 1 to 2 years, 2 years or more Five patients (12%). (2) Clinical manifestations: 38 cases of epigastric pain, 28 cases of hematemesis or melena, 25 cases of loss of appetite, 22 cases of generalized weakness, 21 cases of weight loss, 20 cases of vomiting, 8 cases of abdominal mass, 2 cases of anemia, and neck mass 1 example. (3) Pathological examination: Up to 34 cases (80.9%) of gastric antrum, 3 cases of gastric body, 1 case of stomach bottom, and 4 cases of total stomach. There were 23 poorly differentiated adenocarcinomas, 8 adenocarcinomas, 6 mucinous adenocarcinomas, and 5 undifferentiated carcinomas. (4) Treatment: 36 patients underwent surgery, including palliative resection in 12 cases, radical resection in 13 cases, simple gastrojejunostomy in 5 cases, laparotomy in 6 cases, and the rest were not treated due to severe dyskaryon or distant metastases. .