| Objective The purpose of this study was to clarify the clinico-pathologic features of alpha-fetoprotein-producing gastric cancer (APGC).Patients and Methods In 5 cases with elevated preoperative serum level of AFP among a total of 357 patients who received operations in our hospital from Jan 1, 2005 to Dec 31, 2005 as the treatment of primary gastric cancer, AFP production was detected in gastric cancer cells by immuno-histochemistry. Finally only 3 cases were confirmed to produce AFP and diagnosed as APGC. The expression of VEGF(vascular endothelial growth factor) was also detected in these 3 cases. Another one with same features was found in 2006.Results The morbility of APGC was 0.84%(3/357)according to our research. The serum levels of AFP were from 37.0 to 9276.0 ng/ml. In the 4 APGCs, only one case (25%) was performed radical resection. Lesions in 2 of 4 cases (50%) were penetrated serosa or invaded adjacent structures. Patients with lymph node metastasis and liver metastasis were 67% (2/3) and 50% (2/4) respectively.The stages of these cases were either IIIor IV, and the histologic types were moderate to poor differentiated adeno-carcimoma and/or signet ring cell carcinoma. Positive rate of VEGF immunohistochemical staining was 100%.Conclusion Alpha-fetoprotein-producing gastric cancer is classified as a special subtype of gastric cancer with an aggressive biological behavior.It occurs rare and has a poor prognosis. We should pay more attentions to it in clinical work, especially for the patients with multiple liver lesions and high level of AFP in serum in order to decrease the misdiagnostic rate. It needs a further research whether there is a correlation between the serum level of AFP and the biological behavior of APGC. |
