| Objective: serum AFP positive and some of the common clinical gastric cancer,there are a lot of difference between clinical rare,also belong to a special type of gastric cancer is not similar with the general biological characteristics of gastric cancer,serum AFP positive gastric cancer now a large number of literature data reported is not much,now also started to attach importance to this type of gastric cancer,clinical study the clinical characteristics and prognosis,the serum AFP positive diagnosis and treatment of gastric cancer play a vital role,this research review statistics in the first hospital affiliated to dalian medical university during general 2009.01.01 medicaments to 2012.12.30,proved by surgery and postoperative pathological and clinical data of patients with gastric cancer,serum AFP positive,discussion,producing AFP the clinical features and prognosis of gastric cancer.Methods: a retrospective study of dalian medical university first affiliated hospital general surgery during January 2009 to December 2012,proved by surgery and postoperative pathological and clinical data of patients with gastric cancer,serum AFP positive,eliminate cirrhosis of the liver and the reproductive system tumor,592 cases with statistics,incorporate the serum AFP more than upper limit of normal gastric cancer patients serum AFP positive group of 58 cases of gastric cancer,serum AFP normal range in serum AFP negative group a total of 534 cases of gastric cancer,the research of two groups of patients with gender,age,blood type,family history,serum AFP level,nature of the surgery,surgical resection,tumor site,tumor size,gross type,invasion,histological type,differentiation degree,vascular invasion,neurologic involvement and lymph node metastasis and pathological staging,liver metastasis,extrahepatic metastasis of information and survival,analysis of the clinical pathological characteristics and the factors affecting the prognosisResults:(1),58 cases of serum AFP positive patients with gastric cancer,accounting for 9.7% of the total gastric cancer patients in this study(58/592),and serum AFP negative patients with gastric cancer,compared to its more easily with serosal invasion(67.2% VS 35.2%),vascular invasion(75.9% VS52.1 %),nerve infiltration(31.0% VS 18.4%),clinical stage,late stage Ⅳ VS28.1 %(56.9%),lymph node metastasis(82.8% VS65.5 %),liver metastasis(43.1% VS9.6 %)and extrahepatic metastasis VS8.4 %(20.6%),the difference significance(P 0.05)^(2)The AFP positive group of patients with gastric carcinoma preoperative blood serum AFP level is divided into ug/L < 5.8 AFP acuities were 100 ug/L(n = 49)and 100 ug/L < AFP(n = 9)according to the results in serum AFP 100 ug/L < AFP in patients with liver metastases rate is much higher than the serum AFP level in 5.8 ug/L < AFP acuities were 100 ug/L VS34.7 %(77.8%)patients,was significant statistical difference(P < 0.05).(3)Family history and blood type comparison;Serum AFP positive genetic history ratio(15.8%)than the serum AFP negative group(5.6%),the comparison of differences between the two groups,with statistical significance(P < 0.05),serum AFP positive family history of gastric cancer patients with proportion may be higher than the serum AFP negative patients with gastric cancer,in the ABO blood group,serum AFP positive for type A blood in the gastric cancer group and negative group compared with other blood types.(4)In comparison the prognosis of serum AFP positive group was significantly worse than that of serum AFP negative group.Serum AFP positive patients at 1 year,3 years,5 years survival rate were 74.1%,39.6%,25.8%,and the serum AFP negative group of patients 1 year,3 years,5 years survival rates were 88.1%,69.2% and 56.2% respectively.Multivariate regression analysis;Age,preoperative AFP serum level,pathological stage and liver metastasis were independent risk factors affecting the prognosis of serum AFP positive gastric cancer patients.Conclusion: 1.High malignancy of AFP positive gastric cancer,lymph node and liver metastasis are easier.2.The examination of serum AFP level is significant for the diagnosis and follow-up of serum AFP positive gastric cancer,and the higher the preoperative AFP concentration,the greater the possibility of liver metastasis.3.Patients with AFP positive gastric cancer have a tendency of family history,and the relatives of AFP positive gastric cancer patients suggest gastric cancer screening.4.The prognosis of serum AFP positive gastric cancer patients was poor,pathological stage,serum AFP level,age and liver metastasis were independent risk factors affecting the prognosis of patients. |
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