Advanced gastric cancer in different age groups in contrast to the clinical and pathological feature.docx

Advanced gastric cancer in different age groups in contrast to the clinical and pathological feature.docx

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Advancedgastriccancerindifferentagegroupsincontrasttotheclinicalandpathologicalfeature

AdvancedgastriccancerindifferentagegroupsincontrasttotheclinicalandpathologicalfeaturesofAnalysis

[Abstract]ObjectiveTostudytheyoungandelderlypatientswithadvancedgastriccancer,endoscopiccharacteristicsandclinicalandpathologicalfeatures.MethodinourhospitalinJanuary2000-200912menstrualsurgeryandpathologicallyconfirmed320casesofadvancedgastriccancer（including45youngand275elderlypatientswithgastriccancer）wereretrospectivelyanalyzedresultsofgastriccancersitecomparison,younggrouptothemajorityoftheantrum,cardiaincreasedtheproportionofelderly,withdiffusegastriccancermorecommoninyoung,mostlypoorpathologicaltypepoorlydifferentiatedtype,highlymalignantandtheyouthgroupⅢb,Ⅳperiodtheproportionoflivermetastasis,peritonealmetastasisratehigherthantheoldergroup,thedifferencewasstatisticallysignificant.Conclusionofadvancedgastriccancerinyounghigh-gradediffusemainly,theincidenceisrising,younghighdegreeofmalignancyofgastriccancer,theprognosisispoor,shouldstrengthentheyouthcancerawarenessandvigilance.

[Keywords]youngpathologicalfeaturesofgastriccancerbiologicalbehavioroftheelderlyGastriccancerisoneofthemostcommonhumanmalignancies,theincidencewassignificantlyhigherthaninAsiaEuropeandAmerica,countrieswithhighratesofgastriccancerinChina.Bothmaleandfemaletopsoftheircancerincidenceandmortalityinthefirsttwo,accountingforgastrointestinalcancerthefirst,peakage50to70yearsold.At35yearsofagegastriccancerforyoungpeople[1].gastriccanceroccurintheelderly,butyounginrecentyearsthetrendofincreasingincidenceofgastriccancer.Article200ofthehospitalinJanuary~December2009treated320casesofadvancedgastriccancerpatientswithasummaryanalysisofclinicaldata,andcompareyoungandoldwithdifferentclinicalcharacteristicsofgastriccancerandpathologicalconditions,provideareferenceforclinicaldiagnosisandtreatment.

Objectandmethod1.1ObjectWeretreatedinhospitaluppergastrointestinalendoscopyandbariummealexaminationandconfirmedbypathologyoropensurgeryforadvancedgastriccancer320cases,45cases≤35yearsofage,foryouthgroups,including18malesand27females,meanage26.5years.275patientsaged>60yearsold,asoldagegroup,male210cases,65females,theoldest79yearsold.patientdatawerederivedfromtheoriginalhospitalmedicalrecordsandfollow-upresults.

1.2diagnosticcriteriaforpathologicalUsingtheWHOclassificationcriteria,dividedintopapillarycarcinoma,tubularcarcinoma,mucinouscarcinomaandsignetringcellcarcinoma,degreeofdifferentiationintohighlydifferentiatedtype（includingtubularwelldifferentiated,moderatelydifferentiatedadenocarcinomaandpapillaryadenocarcinoma）andpoorpoorlydifferentiatedtype（includingpoorlydifferentiatedtubular,undifferentiated,andmucinousadenocarcinoma,signetringcellcarcinoma.

1.3endoscopydiagnosticcriteriaAdvancedgastriccanceraccordingtoBormanntypestandardsaredividedintotypeI（polypoid）,Ⅱtype（ulcer-type）,Ⅲtype（ulcerinfiltrating）,Ⅳtype（diffuseinfiltrative）.

1.4MethodsUsingSPSS13statisticalsoftware,usingχ2testforcategoricalvariables.ToP<0.05forthedifferencewassignificant.

2Results2.1ComparingthetumorDiseasesitecanbeseenfromTable1:

agegroup178casesofgastriccardia（64.6%）,youthgroup3patients（7.6%）,gastricbodyagegroupof57patients（20.9%）,youthgroupof12patients（26.7%）,stomachsinusagegroup,28patients（10.3%）,youthgroupof26patients（75.0%）,totalgastrectomyagegroupof6patients（3.2%）,youthgroup1patients（3.1%）.cardiagastriccancergroupwassignificantlyolderthanyounggroup,andgastriccancerwassignificantlylowerthantheyounggroup（P<0.01）.

Table1agegroupandrelativelyyounggroupofgastriccancersite（%Group（n）full-cardiagastricstomachgastricantrumAgegroup（275178（64.6%）57（20.9%）28（10.3%）12（4.2%）

Youth（45）3（7.6%）12（26.7%）26（58.5%）3（7.2%）

2.2gastroscopytypecomparisonBorrmanntypeIcomparedage-groupof51patients（18.4%）,youthgroup,4cases（9.5%）,Ⅱage-groupof150patients（54.6%）,younggroupof8patients（17.8%）,Ⅲage-groupof47patients（17.2%）,youthgroupof16patients（34.2%）,Ⅳage-groupof27patients（9.8%）,youthgroupof10patients（38.5%）agegroupⅠandtypeⅡhigherthantherateoftheyounggroup,andⅢ,typeⅣyounggroupthaninthehighrateofelderlypatients,thedifferenceswereverysignificant（P<0.01）.

Table2elderlygroupandyounggroupofgastricendoscopytypecomparison（%Group（n）ItypetypetypeⅡⅢⅣtypeAgegroup（27551（18.4%）150（54.6%47（17.2%27（9.8%

Youth（454（9.5%8（17.8%16（34.2%17（38.5%

2.3HistologicalclassificationmoreTable3,poorlydifferentiatedpoorelderlygroupof94patients（34.0%）,youthgroup,39patients（85.8%）,thetwogroups,P<0.01,inwell-agedgroup153cases（55.8%）,youthgroup6patients（14.2%）,thetwogroups,P<0.01.

Table3agegroupswiththeyounggroupofgastriccancerhistologicaltypecomparison（%Group（n）well-differentiatedcancer,poorlydifferentiatedcarcinomaofpoorcancerAgegroup（275）28（10.2%）153（55.8%）94（34.0%）

Youth（45）0（06（14.2%）39（85.8%）

2.4TNMstageandmetastasiscomparedTwogroupsofelderlypatientswithTNMstagegroupsⅡ,Ⅲaperiodof187cases（67.9%）,Ⅲb,Ⅳperiodof88cases（32.1%）,livermetastasisin6cases（2.3%）,peritonealmetastasisin23cases（8.5%）;YouthTNMstageⅡ,Ⅲaperiodof19cases（36.5%）,Ⅲb,Ⅳperiodof27cases（63.5%）,livermetastasesin6cases（9.3%）,peritonealmetastasisin17patients（25.5%）theyouthgroupⅢb,Ⅳphasewas,livermetastasis,peritonealmetastasiswerehigherthantheoldgroup（P<0.05）.Linkstofreediscussionpaperdownload

3

Nearly40years,theyoung5-yearsurvivalofgastriccancerhasnotimprovedsignificantly,therefore,shouldincreasethevigilanceoftheyouthcancer,strengthenthestomachoutsidetheperformanceandthetransferofknowledgeofsymptoms,importanceofearlydiagnosisofsuspectedcasesshouldbeactivelypursuedthestomachmicroscopyandpathologytrack.endoscopiccharacteristicsofyounggastriccancerwiththepredilectionsitesofdifferentageinthisgroupofmiddle-agedgroupantrumcanceraged28cases（10.3%）,youthgroupof26patients（75.0%）,cardia178casesofgastricagegroup（64.6%）,youthgroup3patients（7.6%）,gastricbodyoldagegroup,57patients（20.9%）,youthgroupof12patients（26.7%）,thewholestomachagegroupof6patients（3.2%）,youthgroup1patients（3.1%）agegroupatthebottomofgastriccardiacancerincidenceintheyouthgroupandyouthgroupofgastriccancerincidenceintheelderlygroup.occurinthegastricantrumwiththeliteraturesimilar.Thispredilectionsitesofdifferentreasonsarenotclearfromthehistologicalview,thehumangastricepithelialdegenerationandintestinalmetaplasiaincreasedwithage,withcardiagastricantrumtothedirectionofthetrend,butwithage,theoccurrenceofinthegastriccardiapartoftheincreaseintheproportionofpatients.esophagealsmoothmuscledegenerationduetotheelderly,lowloweresophagealsphincter,andpronetonervousdisordersregulatorymechanisms,leadingtostomachanesophagealreflux,recurrentinflammatorydamagecausedbycardiacregion,repair,hyperplasia,andfinallytheformationofcancer[2].

Thedataalsoshowthatthepathologicaldegreeofdifferentiationandgeneralclassificationtwodifferentagegroupstherearesignificantdifferences,withincreasingage,theproportionofwell-differentiatedtypeofgastriccancerincreasedtheyounggrouptheproportionofpoorlydifferentiatedadenocarcinomathantheoldergroup,whiledifferentiatedadenocarcinomawithlessthantheoldergroup,suggestingthatwithage,thebetterthedegreeofdifferentiationgraduallyincreasedtheproportionofcancer,indicatingahighdegreeofmalignancyofgastriccancerinyoungpeople,invasiveability,andearlytransfer,theelderly,gastriccancerweak,relativelylatetransfersbecauseofpooryoungpeopleingastriccancercelldifferentiation,biologicalbehaviorthantheevil,diffusegrowth,easytoinfiltratemuscularisandserosa,sothelargelesionsmorecommoninelderlygastriccancercellsarerelativelygood,moderategrowth,mostlylumpygrowth,itisrelativelysmalllesionsfromthisgroupofpatientstoseeyoungpeoplewithcancerhistologicaltypeofpoorlydifferentiatedadenocarcinoma,mucinouscarcinoma,signetringcellcarcinomaandundifferentiatedcarcinomamorecommon,Andthesetypesoftumorshaveahighdegreeofmalignancy,whichalsodeterminestheyoungcancerdiseaseprogression,pronetoearlymetastasis,poorprognosis,theyouthgroupofwell-differentiatedadenocarcinoma,andfarlessthanintheoldergroup,butthediffusetypegastriccancerissignificantlymorethantheoldergroup,particularlyundifferentiatedcarcinomaandsignetringcellcarcinoma,suggestingthatthesetwopatientswithgastriccancerinyoungpeopleplaysanimportantrole,suggestingthattheincidenceofgastriccancerwithage,genderarerelated[3].

Thedatashow:

theyounggrouptoinvasiveulcerativeformofgastriccancer,diffuseinfiltratingtype,accountingforabout72.7%inelderlygroupofpolypsandulcerativeaccounted73%,BorrmannⅡ,Ⅲ,Ⅳmainlytothedeepinfiltration,caneasilypenetratethemusclelayerdipmadeserosa,withearly