OBJECTIVE This study was designed to determine theclinicopathologic features of young patients who underwentgastrectomy for gastric cancer and to improve the clinicalmanagement of this disease.METHODS From 1981 to 200...OBJECTIVE This study was designed to determine theclinicopathologic features of young patients who underwentgastrectomy for gastric cancer and to improve the clinicalmanagement of this disease.METHODS From 1981 to 2000,among 1,830 gastric cancerpatients were admitted in our hospital for surgical treatment,66of them were<36 years of age.The clinicopathologic data of theseyoung patients were collected and reviewed.RESULTS The male:female ratio was 1.2:1.Most tumors werelocated in the lower third of the stomach(63.1%).The overall5-year survival rate of 66 cases was 28.7%.The 5-year survivalrates in the patients with early stages and with advanced stages ofgastric carcinoma were 77.8%(7/9)and 21.1%(12/57),respectively.Unfavorable prognostic factors associated with poor 5-yearsurvival included the degree of the invasion in the gastric wall(P<0.05),and curability of resection(non-curative vs.curative;P<0.05).CONCLUSION Gastric cancer in young adults tends to be moreadvanced presentation when diagnosed.However,young patientswith early gastric cancer can tolerate radical treatments well.Itis important to promptly make a precise diagnosis for gastriccarcinoma in young patients and to treat it in early stage.展开更多
Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma d...Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.展开更多
文摘OBJECTIVE This study was designed to determine theclinicopathologic features of young patients who underwentgastrectomy for gastric cancer and to improve the clinicalmanagement of this disease.METHODS From 1981 to 2000,among 1,830 gastric cancerpatients were admitted in our hospital for surgical treatment,66of them were<36 years of age.The clinicopathologic data of theseyoung patients were collected and reviewed.RESULTS The male:female ratio was 1.2:1.Most tumors werelocated in the lower third of the stomach(63.1%).The overall5-year survival rate of 66 cases was 28.7%.The 5-year survivalrates in the patients with early stages and with advanced stages ofgastric carcinoma were 77.8%(7/9)and 21.1%(12/57),respectively.Unfavorable prognostic factors associated with poor 5-yearsurvival included the degree of the invasion in the gastric wall(P<0.05),and curability of resection(non-curative vs.curative;P<0.05).CONCLUSION Gastric cancer in young adults tends to be moreadvanced presentation when diagnosed.However,young patientswith early gastric cancer can tolerate radical treatments well.Itis important to promptly make a precise diagnosis for gastriccarcinoma in young patients and to treat it in early stage.
文摘Early gastric carcinomas may develop with a molecular profile differing from sporadic carcinomas occurring at a later age. In this study, we analyzed a retrospective series of 88 patients with gastric adenocarcinoma diagnosed before the age of 45 years for the presence of TP53 mutations, clinicopathological features and immunohistochemistry to evaluate the expression of markers considered to be important in gastric carcinogenesis (E-cadherin, β-catenin, MUC1, MUC2, MUC5AC, MUC6 and p53). The majority of proportion of tumors were diffuse-type (70%) and advanced stage (56%). Familial history of cancer was positive in 21% of the cases. There was a significant association between altered expression of E-cadherin and β-catenin, and between p53 expression and perineural invasion. TP53 mutations were detected in 14.5% of evaluated cases, including a germline mutation (p.R337H) in a 12-year old patient. Overall survival analysis showed significant differences in relation with tumor stage and histopathology. The evaluated biomarkers did not present prognostic value in non-exploratory multivariate analyses. The low frequency of TP53 mutations in this series suggests these alterations are not a major molecular event in gastric cancer occurring at early age, although the identification of a case with germline p.R337H mutation is consistent with the hypothesis that a small proportion of early, apparently sporadic gastric cancer, may be associated with widespread Brazilian founder mutations. Further studies are needed to evaluate the prognostic significance of markers for specific groups of patients according to tumor histology and familial history.
