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目的 了解青年人与老年人早期胃癌的特点和差异,采取更为合理的治疗手段。方法 对比分析1990～1999年经外科手术治疗且病理证实的30岁以下早期胃癌20例、60岁以上早期胃癌39例的临床及随访资料。结果 青年组发病年龄平均(25.1±2.3)岁,老年组发病年龄平均(64.9±4.4)岁。青年组男:女=1:1.5,老年组男:女=3.9:1(P<0.05)。青年组胃底贲门癌2例(10.0％),老年组12例(30.8％);青年组胃体癌8例(40.0％),老年组16例(41.0％);青年组胃窦癌10例(50.0％),老年组11例(28.2％)(P<0.01)。青年组分化较好的胃癌6例(30.0％),老年组23例(59.0％),P<0.05。多数病例经D_2根治术。青年组术后5年生存率85.7％,老年组90.5％(P>0.05)。结论 青年人早期胃癌以女性多见,多位于胃窦部且分化较差;老年人早期胃癌以男性多见,多位于胃底贲门且分化较好。二者5年生存率相似,因而早期诊断、早期行根治性手术,可能是影响胃癌预后最重要的一个因素。
Objective To understand the characteristics and differences of early gastric cancer in young and old people and to adopt a more reasonable treatment. Methods The clinical and follow-up data of 20 cases of early gastric cancer under 30 years of age and 39 cases of early gastric cancer over 60 years of age surgically treated from 1990 to 1999 were analyzed. Results The average age of onset in the youth group was (25.1 ± 2.3) years old, and the average age of onset in the elderly group was (64.9 ± 4.4) years. Male: female = 1: 1.5 in the youth group, male: female = 3.9: 1 in the elderly group (P <0.05). In the youth group, gastric cardia carcinoma in 2 cases (10.0%) and elderly group (12 cases) were in 12 cases (30.8%). In young group, 8 cases (40.0%) had gastric cancer and 16 cases (41.0% (50.0%) in the elderly group and 11 cases (28.2%) in the elderly group (P <0.01). There were 6 cases (30.0%) of well-differentiated gastric cancer in young group and 23 cases (59.0%) in elderly group, P <0.05. Most cases by D_2 radical mastectomy. The 5-year survival rate was 85.7% in the youth group and 90.5% in the elderly group (P> 0.05). Conclusion Early gastric cancer in young people more common in women, mostly located in the antrum and poorly differentiated; elderly early gastric cancer more common in men, mostly in the gastric cardia and well differentiated. Both 5-year survival rates are similar, so early diagnosis, early radical surgery may be the prognosis of gastric cancer is the most important factor.