许昌地区不同性别及年龄组胃癌患者的临床病理特征分析

发布时间：2018-06-23 21:02

本文选题：胃癌 + 性别　；参考：《新乡医学院》2016年硕士论文

【摘要】：背景胃癌是发生于胃上皮组织的恶性肿瘤,是全世界最常见的恶性肿瘤之一。据统计,全球每年新发胃癌约有100万例,同时每年约有60万人因胃癌死亡,居于所有癌症死因的第二位。因此,早发现、早治疗、进行早期干预是提高患者生存期的重要手段。大量文献针对老年胃癌患者和青年胃癌患者的临床病理特征进行了对比研究,但是鲜有针对中年胃癌患者的研究,而是笼统地把中年人归于中老年人的范畴。目的探讨不同性别及年龄组胃癌患者的临床病理特点,从个体化的视角来研究青年男性、中年男性和老年男性各组之间的差异以及青年女性、中年女性和老年女性各组之间的差异,尤其把中年胃癌患者作为一个独立的研究对象,旨在通过更加细化的分类方法来进行更加具有针对性的研究,以期能为胃癌的预防和诊疗提供较为全面且更有针对性的依据。方法回顾性分析许昌市中医院2014年01月至2015年01月确诊的263例胃癌患者的临床资料,依据性别及2000年WHO对于年龄的界定范围,分为青年男性组、中年男性组和老年男性组以及青年女性组、中年女性组和老年女性组。从个体化的视角来分析许昌地区青年男性、中年男性和老年男性各组之间的临床病理差异以及青年女性、中年女性和老年女性各组之间的临床病理差异。采用SPSS17.0对青年男性组、中年男性组和老年男性组三组数据进行分析,如差异具有显著性,再进行两两对比,明确差异的来源,同样的方法也应用于女性各年龄组。结果1.本研究中,263例胃癌患者,男性186例,女性77例,男女性别构成比为2.41:1。其中青年男性11例,青年女性16例,男女构成比为1:1.45;中年男性82例,中年女性26例,男女构成比为3.15:1;老年男性93例,老年女性35例,男女构成比为2.66:1。2.在病变部位上,总体来看,许昌地区胃癌患者发病部位的排序为胃窦贲门胃底胃体全胃。老年男性胃体部发病率高于中年男性,两组之间比较差异有统计学意义(p0.05);其余男性患者各年龄组在各部位的发病率上无显著性差异(p0.05)。女性患者各年龄组在各部位的发病率上均无显著性差异(p0.05)。3.在大体分型上,许昌地区中年男性组在borrmannⅡ型的构成比上显著高于老年男性组(p0.05)。女性患者各年龄组在大体分型的构成比上均无显著性差异(p0.05)。4.在组织学分型上,许昌地区老年男性组中分化腺癌的构成比显著高于青年男性组和中年男性组(p0.05);青年男性组在粘液腺癌的构成比上显著高于老年男性组(p0.05)。女性患者中,青年女性组在未分化癌的构成比上显著高于老年女性组(p0.05)。5.在病理分期上,许昌地区青年男性组在tnm分期中Ⅲ期的构成比上显著高于中年男性组(p0.05)。女性患者中,各年龄组女性在各tnm分期的构成比上无显著性差异(p0.05)。6.在临床表现上,总体来看,许昌地区胃癌患者最常见的临床表现是腹痛,其次是食欲不振、呕血黑便等。中年男性组上腹疼痛的发生率高于青年男性组和老年男性组(p0.05);老年男性组消瘦的发生率显著高于中年男性组(p0.001);老年男性组吞咽困难的发生率显著高于中年男性组(p0.001)。女性患者中,老年女性组消瘦的发生率高于中年女性组,(p0.05);其余各年龄组女性在各种临床表现的发生率上无显著性差异(p0.05)。7.在家族史、吸烟史及饮酒史上,许昌地区男性各组间及女性各组间均无显著性差异(p0.05)。8.在高血压、糖尿病等合并症上,许昌地区男性各组间及女性各组间均无显著性差异(p0.05)。结论1.许昌地区,男性胃癌发病率高于女性,中年胃癌患者男女构成比最高,青年人胃癌女性显著高于男性。2.许昌地区青年患者,尤其青年女性患者胃癌的组织形态、生物学行为均显著差于中老年患者;中年患者病灶较局限;中年患者的腹痛症状以及老年患者的消瘦和吞咽困难症状较为显著。
[Abstract]:Background gastric cancer is a malignant tumor occurring in the epithelial tissue of the stomach. It is one of the most common malignant tumors in the world. According to statistics, there are about 1 million cases of new gastric cancer in the world every year. At the same time, about 600 thousand people are died of gastric cancer each year, and second of all the causes of cancer death are in the world. Therefore, early detection, early treatment and early intervention are to improve the survival period of the patients. The clinicopathological features of the elderly gastric cancer patients and young gastric cancer patients were compared in a large number of literatures, but there were few studies on the middle aged gastric cancer patients, but in general, the middle-aged people were classified in the category of middle aged and old people. To study the differences between young men, middle-aged men and older men, and the differences between young women, middle-aged women and older women, especially middle-aged patients with gastric cancer as an independent study, aimed at making more specific research through a more detailed classification, with a view to the stomach. The prevention and diagnosis and treatment of cancer provide a more comprehensive and more targeted basis. Methods a retrospective analysis of the clinical data of 263 cases of gastric cancer diagnosed by Xuchang Hospital of Traditional Chinese Medicine from 01 months to 01 months from 2014 to 2015 was divided into young male group, middle-aged male group, old male group and young woman according to sex and the definition range of WHO for age in 2000. The clinicopathological differences between young men, middle-aged men and elderly men in Xuchang area, and the clinical pathological differences between young women, middle-aged women and older women were analyzed from a individualized perspective. The SPSS17.0 was used for young men, middle-aged men and elderly men. The data of group three were analyzed, for example, the difference was significant, and then 22 contrasts were made. The same method was used in women's age groups. In the 1. study, 263 cases of gastric cancer, 186 male and 77 female, 11 cases of young men and 16 young women, and the ratio of male and female to male and female. 1:1.45, 82 middle-aged men and 26 middle-aged women, the ratio of men and women was 3.15:1, 93 aged men and 35 elderly women, and the ratio of male and female to 2.66:1.2. was on the lesion. In general, the incidence of gastric cancer in Xuchang area was the gastric antral gastric fundus gastric fundus and the whole stomach. The incidence of gastric body in the elderly male was higher than that of the middle-aged men and two groups. There was no significant difference between the different age groups in the rest of the male patients (P0.05). There was no significant difference in the incidence of all parts of the age group of the female patients (P0.05), and there was no significant difference in the incidence of each age group (P0.05) in the general classification, the middle age male group in Xu Changdi district was significantly higher than that of the Borrmann type II. The elderly male group (P0.05). There was no significant difference in the composition ratio of all age groups in female patients (P0.05).4. in the organizational credit type, the proportion of differentiated adenocarcinoma in the elderly male group in Xuchang was significantly higher than that in the young male group and the middle age group (P0.05), and the composition ratio of the young male group in mucous adenocarcinoma was significantly higher than that of the old group. In the male group (P0.05). In female patients, the composition ratio of undifferentiated cancer was significantly higher in the young women group than in the elderly female group (P0.05).5. in the pathological stage. The composition ratio of the young male group in the Xuchang area was significantly higher than that in the middle age group (P0.05) in the TNM staging. Women in all age groups were in the constituent ratio of the TNM staging. There was no significant difference (P0.05).6. in clinical manifestations. In general, the most common clinical manifestations of gastric cancer in Xuchang were abdominal pain, followed by anorexia, hematemesis and stool. The incidence of upper abdominal pain in middle-aged men was higher than that of young men and old men (P0.05); the incidence of emaciation in the elderly male group was significantly higher than that of middle-aged men. Group (p0.001); the incidence of dysphagia in the elderly male group was significantly higher than that in the middle age group (p0.001). The incidence of emaciation in the elderly female group was higher than that of the middle-aged female group (P0.05). There was no significant difference in the incidence of various clinical manifestations among the other age groups (P0.05).7. in family history, smoking history and drinking history, Xuchang There was no significant difference between the male and female groups in the region (P0.05).8. in hypertension, diabetes and other complications, there was no significant difference between the male and female groups in Xuchang region (P0.05). Conclusion 1. Xuchang area, the incidence of male gastric cancer is higher than that of women, middle age gastric cancer patients have the highest proportion of men and women, young people with gastric cancer. Significantly higher than male.2. Xuchang young patients, especially young women with gastric cancer tissue morphology, biological behavior is significantly worse than the elderly patients, middle-aged patients with limited focus, middle-aged patients with abdominal pain symptoms and elderly patients with thin and dysphagia symptoms are more significant.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.2

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