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1、青年人胃癌的临床研究【摘要】口的探讨青年人胃癌的发病特点及临床病理特征。方法回顾分析64例青年人胃癌(W35岁)和185例老年人胃癌($60岁)的临床资料。比较两组患者的临床症状、幽门螺杆菌(Hp)感染、病变部位、病程、Borrmann分型、病理类型及预后。结果青年组胃癌女性多发，男女之比为1：1.78,临床首发症状以上腹部疼痛、上腹部饱胀等为主，Hp感染率明显高于老年组(P<O.05);青年组病程以<3个月、老年组以>6个月为主(P<0.01)o青年组胃癌发病部位以胃窦为主，老年组以胃底贲门多见(P<0.01
2、)。青年组病理类型以Borrmannlll.IV型和低分化腺癌多见，老年组以高分化腺癌居多(P<0.01或P<0.05)o5年生存率青年组低于老年组(P<O.05)o结论与老年人胃癌相比，青年人胃癌恶性程度高，分化低，进展速度快，预后差。早期发现、尽早实施根治手术切除是提高治愈率和生存率的关键。【关键词】胃肿瘤;青少年;病理学，临床Abstract:ObjectiveToinvestigatetheclinicalsymptomsandtheclinico-pathologicalcharacteristicsinyoun
3、gpatientswithgastriecarcinoma・MethodsTheclinicalpathologicalrecordsof64youngpatients(aged35yearsoryounger)and185elderlypatients(aged60yearsorolder)wereretrospectivelyanalyzed・Clinicalmanifestation,Helicobacterpyloriinfection,lesionlocation,diseasecourse,Borrmanntyping,path
4、ologicaltypeandprognosisbetweenthetwogroupswereanalyticallycompared・ResultsIntheyouthgroup,thereweremorefemalepatients,theratioofmaletofemalewas1:1.78.Thereweremorecaseswithepigastriumpain,epigastriumdistendasthefirstoccurredclinicalmanifestation.Helicobacterpyloriinfectio
5、ncasesinyouthgroupweresignificantlymorethanthoseinelderlygroup(P&It;0.05).Durationofdiseaseintheyouthgroupwas1essthan3months,andtheelderlygroupwaslongerthan6months(P&It;0.01).Thetumorsitesoforiginintheyouthgroupweremainlylocatedingastricsinus,andtheelderlygroupmainlyingast
6、riccardia(P&It;0.01).Pathologicfeatures,BorrmannIIIorIVandpoorlydifferentiatedadenocarcinomawereprevalentintheyouthgroup,andwel1differentiatedadenocarcinomawereprevalentintheelderlygroup(P<0.01orP&It;0.05).The5-yearsurvivalratewasobviouslylowerintheyouthgroupthanthatine
7、lderlygroup(P&It;0・05)・ConclusionComparedtotheelderly,youngpatientswithgastriccarcinomascarryworsedegree,1owerdifferentiation,fasterprogressandpoorerprognosis・Earlyidentification,radicalresectiontreatmentarenecessarytoimprovecurativeandsurvivalratesforyoungpatients.Keyword
8、s:stomachneoplasms:adolescence;pathology,clinical胃癌是世界范围内最常见的恶性肿瘤之一，位居癌症死因的第二位［1］。其发病高峰为5
