CAJ | 학술논문

　　目的探讨青年与老年胃癌的临床、内镜、术后病理特点及预后。方法回顾性总结我院2003年12月～2012年12月经胃镜检查，手术确诊的青年人（≤35岁）胃癌51例及老年人（≥65岁）胃癌284例，进行临床表现、内镜表现、术后病理分型及预后等对比分析。结果近年来，胃癌患病总人数下降，同期内老年人胃癌总人数多于青年人；青年组胃癌以女性多，老年组以男性多；青年组多在胃下1/3，老年组多在胃上1/3；内镜下青年组多表现为BorrmannⅢ、BorrmannⅣ，术后病理以低分化腺癌、黏液腺癌、印戒细胞癌为主；老年组以BorrmannⅠ、BorrmannⅢ为主，术后以高-中分化腺癌居多；两组胃癌手术方式无差异性；老年组1年、3年生存率高于青年组。结论青年人胃癌临床症状隐匿，病理分化差，预后差。早期胃镜检查、定期复查、幽门螺杆菌根除、手术是青年人胃癌治疗的关键。
　　목적탐토청년여노년위암적림상、내경、술후병리특점급예후。방법회고성총결아원2003년12월～2012년12월경위경검사，수술학진적청년인（≤35세）위암51례급노년인（≥65세）위암284례，진행림상표현、내경표현、술후병리분형급예후등대비분석。결과근년래，위암환병총인수하강，동기내노년인위암총인수다우청년인；청년조위암이녀성다，노년조이남성다；청년조다재위하1/3，노년조다재위상1/3；내경하청년조다표현위BorrmannⅢ、BorrmannⅣ，술후병리이저분화선암、점액선암、인계세포암위주；노년조이BorrmannⅠ、BorrmannⅢ위주，술후이고-중분화선암거다；량조위암수술방식무차이성；노년조1년、3년생존솔고우청년조。결론청년인위암림상증상은닉，병리분화차，예후차。조기위경검사、정기복사、유문라간균근제、수술시청년인위암치료적관건。
Purpose To investigate the characteristics and differences of gastric cancer between old pa-tients and young patients in the clinical manifestation, treatment and prognosis. Methods Fifty-one young pa-tients(≤35 years old) with gastric cancer from December, 2003 to December, 2012 were retrospectively ana-lyzed, and compared with 284 elderly (≥65 years old) patients with gastric cancer according to clinical and pathological data. Results Young gastric cancer accounts for 6.9%of all gastric cancer patients during the study period. Detectable rate of young female gastric cancer was higher than male. The symptoms of young patients with gastric cancer were not typical. The antral gastric cancer was not rare, and cardiac cancer was common in eldly group. Most of them were found at progressive stage. Ulcerated infiltrating types were the most common type, with early metastasis. Poorly differentiated adenocarcinoma and signet ring cell carcinoma were common in young group. There were more cases with well and moderately differentiated adenocarcinoma in eldly group which were mainly Borrmann TypeⅠandⅢ. Helicobacter pylori infection, dietary habits, family enviroment were related to young gastric cancer. There was no significant difference between radical re-section rate and resection rate between two groups. However, 1-year and 3-year survival rate were lower in young group than eldly group. Conclusion The prognosis of young patients with gastric cancer was poor,there-fore, the early diagnosis and treatment must be strengthened.