108例老年人胃癌临床病理特点及生存分析

摘要/Abstract

摘要： 目的探讨老年人胃癌的临床病理特点及总体生存情况，为早期诊断及治疗提供基础。方法将我院2005年6月至2010年12月住院期间经术后病理证实的有完整资料的胃癌病人245例分为老年组（年龄≥60岁）和中青年对照组（年龄<60岁），其中老年组108例，中青年对照组137例，并对二者的临床特点、病灶部位、病理类型、临床分期及生存情况进行回顾性分析。结果 108例老年胃癌患者男性比例高于女性（χ2=5.56,，P=0.018），临床症状以腹胀，腹痛多见；病变部位以胃窦为主，胃底贲门癌的比例高于对照组（χ2=6.50，P= 0.011）；病理组织学类型以低分化腺癌为主，高中分化腺癌比例明显高于对照组（ (χ2=14.17，P=0.000）；临床分期以III期，IV期占多数；老年组总体中位生存期27个月，总体生存率低于中青年组（χ2=9.35，,P=0.002），两组中均行根治性切除术者的总体生存率相比老年组低于中青年组（χ2=3.98，P=0.046），但老年组中行根治性切除术者与未行根治性切除术者生存率相比前者高于后者（χ2=8.24，P=0.004），老年组根治性切除术后总体1年，3年，5年生存率分别为76%，50%，41%。结论老年人胃癌以男性居多，临床症状不典型，起病隐匿，进展相对缓慢，病变部位中胃底贲门癌比例相对较高，病理组织学分化相对较好，总体生存率低，尽早行根治性切除治疗有助于提高生存率，改善预后。

关键词: 老年人, 胃癌, 临床病理, 生存分析

Abstract: 【Abstract】 Objective To investigate clinicopathologic characteristics and analyse survival rate of 108 old patients with gastric cancer in order to provide the basis for early diagnosis and treatment. Methods From June 2005 to December 2010,245 patients with gastric cancer confirmed by pathology after surgery in our hospital were divided into two groups and the clinicopathologic characteristics and survival rates of the two groups were analysed and compared retrospectively. Results The incidence of gastric cancer in the old male group was higher than in the old female group（χ2=5.56,P=0.018）.In the old group ,abdominal distension and abdominal pain were the most common symptoms.The sites of cancer were mainly gastric antrum in the old group,but the old group with gastric cancer of cardia and fundus constituted a higher proportion compared to the control group(χ2=6.50，P=0.011).The gastric cancer in the old group was mainly poorly differentiated adenocarcinoma while the proportion of well-differentiated adenocarcinoma was higher than the control group (χ2=14.17，P=0.000).The clinical stage of most old patients were III and IV.The median survival time was 27 months in the old group .The overall survival rate of the old group was lower than the control group (χ2=9.35，,P=0.002) .After radical resection,the survival rate of the old group was still lower compared to the control group(χ2=3.98，P=0.046 ),but in the old group ,the survival rate of those who had got radical resection (χ2=8.24，P=0.004 ) was higher and a total of 1,3,5-year survival rates were 76%,50%and 41% respectively.Conclusion Gastric cancer in old patients is common in male , it has uncharacteristic clinical symptoms and progresses slowly,. the overall survival rate is very low.,early radical resection is helpful to improve the overall survival rate and prognosis.

Key words: Survival analysis

中图分类号:

R573.9

侯婧瑛向仍运王凌云. 108例老年人胃癌临床病理特点及生存分析[J]. 岭南现代临床外科, 2011, 11(06): 412-416.

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