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目的分析青海省境内河湟谷地青年型胃癌临床病理特征。方法对2003年2月至2013年2月间青海大学附属医院及青海省人民医院收治的580例青年型胃癌患者临床病理资料进行回顾性分析,按照时间先后顺序分为近5年组与远5年组,按照发病年龄设立青年型胃癌组(580例)和中老年型胃癌组(1 799例)进行病例对照研究。结果近5年组与远5年组青年型胃癌发病部位分析,组间差异具有统计学意义(χ2=25.083,P=0.000);不同分化类型的构成比在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=274.473,P=0.000);鳞癌/腺鳞癌、印戒细胞癌构成比在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=57.642,P=0.000);HER2检测结果在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=104.446,P=0.000);早期胃癌各型在青年型胃癌组与中老年型胃癌组中的构成比差异无统计学意义(χ2=3.099,P=0.541);进展期胃癌Borrmann分型在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=174.065,P=0.000);幽门螺杆菌(Hp)检测结果在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=224.847,P=0.000);Lauren分型在青年型胃癌组与中老年型胃癌组间差异具有统计学意义(χ2=683.671,P=0.000)。结论远端胃(胃下1/3)是河湟谷地青年型胃癌的好发部位,近端胃癌以男性居多;青年型胃癌HER2检测阳性率高于中老年型胃癌,且Hp感染率高;青年型胃癌以低分化、中低分化为主,Lauren分型以弥漫型为主。
Objective To analyze the clinicopathological characteristics of young gastric cancer in Hehuang Valley in Qinghai Province. Methods The clinical and pathological data of 580 cases of young patients with gastric cancer admitted to the Affiliated Hospital of Qinghai University and Qinghai Provincial People’s Hospital from February 2003 to February 2013 were retrospectively analyzed and divided into five groups according to time sequence: In the year-old group, a case-control study was conducted in accordance with the age of onset to establish a group of young-type gastric cancer (580 cases) and a middle-aged group of gastric cancer (1,799 cases). Results The incidence of juvenile gastric cancer in the recent 5-year and far-5-year groups was statistically significant (χ2 = 25.083, P = 0.000). The proportions of different types of differentiation were significantly different between young gastric cancer group and middle-aged gastric cancer There was significant difference between the two groups (χ2 = 274.473, P = 0.000). The differences between squamous cell carcinoma, adenosquamous carcinoma and signet ring cell carcinoma were statistically significant (χ2 = 57.642, P = 0.000). There was a significant difference between the HER2-positive gastric cancer group and the middle-aged and elderly gastric cancer group (χ2 = 104.446, P = 0.000) (Χ2 = 3.099, P = 0.541). The Borrmann classification of advanced gastric cancer was significantly different between young gastric cancer group and middle-aged gastric cancer group (χ2 = 174.065, P = 0.000). The detection results of Helicobacter pylori (Hp) were statistically different between young gastric cancer group and middle-aged elderly gastric cancer group (χ2 = 224.847, P = 0.000) Type gastric cancer group was statistically significant (χ2 = 683.671, P = 0.000). Conclusion The distal stomach (lower third of the stomach) is the predilection site for young gastric cancer in Hehuang Valley, and the majority of proximal stomach cancer is male. The positive rate of HER2 in young stomach cancer is higher than that of middle - aged stomach cancer, and the infection rate of Hp is high. Young type gastric cancer with poorly differentiated, low-grade-based, Lauren type diffuse mainly.