CAJ | 학술논문

目的探讨青年人与老年人直肠癌的临床病理特征及预后的差异.方法回顾 1996年1月至2006年1月可手术的85例青年人(≤40岁)直肠癌与155例老年人(≥65岁)直肠癌患者的临床病理资料和随访资料,进行生存分析和预后多因素分析.结果青年人直肠癌发生在腹膜返折下占69.41%,高于老年组的52.90%(P=0.013);低分化腺癌及黏液、印戒细胞癌比例分别为31.76%及22.35%,也分别高于老年组的18.71%及8.39%(P=0.023,P=0.007);青年组有淋巴结转移者为63.53%,高于老年组的47.10%(P=0.015);青年组与老年组的5生存率分别为48.2%、55.7%,两组差异无统计学意义(P=0.176);多因素分析结果显示,手术性质、肿瘤侵犯深度、淋巴结转移、TNM分期是影响预后最重要的独立因素.结论与老年患者相比,青年患者直肠癌恶性度较高,发现较晚,但若能及早发现并通过根治手术为主联合放化疗,预后可与老年患者无差异.
목적 탐토청년인여노년인직장암적림상병리특정급예후적차이.방법 회고 1996년1월지2006년1월가수술적85례청년인(≤40세)직장암여155례노년인(≥65세)직장암환자적림상병리자료화수방자료,진행생존분석화예후다인소분석.결과 청년인직장암발생재복막반절하점69.41%,고우노년조적52.90%(P=0.013);저분화선암급점액、인계세포암비례분별위31.76%급22.35%,야분별고우노년조적18.71%급8.39%(P=0.023,P=0.007);청년조유림파결전이자위63.53%,고우노년조적47.10%(P=0.015);청년조여노년조적5생존솔분별위48.2%、55.7%,량조차이무통계학의의(P=0.176);다인소분석결과현시,수술성질、종류침범심도、림파결전이、TNM분기시영향예후최중요적독립인소.결론 여노년환자상비,청년환자직장암악성도교고,발현교만,단약능급조발현병통과근치수술위주연합방화료,예후가여노년환자무차이.
Objective To investigate the differences of clinicopathologic characteristics and prognosis between young and old age patients with rectal cancer. Methods From January 1996 to January 2006, 85 young patients(age≤40 years) and 155 older patients(age≥65 years)with rectal cancer were surgically treated. The clinicopathological and follow-up data of them were retrospectively analyzed and compared by survival analysis and COX regression multivariate analysis. Results Rectal cancer under peritoneal in young group were higher than that in older group (69.41 % vs 52.90 %, P =0.013). The young group had significantly higher frequencies of pooly differentiated carcinoma (31.76 % vs 18.71 %, P =0.023) and more mucinous adenocarcinoma as well as signet-ring cell carcinoma (22.35 % vs 8.39 %, P =0.007), There were more lymphatic metastasis in young group than that in old group (N_1+N_2: 63.53 % vs 47.10 %, P =0.015). The overall 5-year survival rates were 48.2 % and 55.7 % in young and old patients respectively, which was not significantly different (P =0.176). COX regression showed that radical operation, tumor infiltration depth,lymph node metastasis and TNM stage were independent prognostic factors. Conclusion As compared to the old age patients, more malignancy and more advanced stage are common in young patients with rectal cancer.However the efficacy of young patients is similar to the older counters by early detection and radical operation combined radiotherapy as well as chemotherapy.