| Background: Alpha-fetoprotein (AFP) was initially found in the humanfetus and was normally produced in the fetal liver and yolk sac. The elevationof serum AFP level was often considered to be abnormal in adult. AFP wasconsidered to be a useful tumor marker in screening or monitoring patients withprimary hepatocellular carcinomas or yolk sac tumors. Recent years,somestudies showed that the other tumors in human could also produce AFP andgastric cancer was one of the most common. Bourreille et al first reported acase of AFP positive gastric cancer in1970. Since then, lots of cases of AFPpositive gastric cancer have been reported. And some studies showed that AFPpositive gastric cancer always had the features of advanced stage, livermetastasis, and poor prognosis. Koide et al found that compared with AFPnegative gastric cancers,AFP positive gastric cancer had higher proliferativeactivity, weaker apoptosis, and richer neovascularization. All above, all thesestudies indicated that AFP positive gastric cancer had high malignant potential.However, most of these studies were case reports, and there were few studiesconcerning the clinicopathologic features and long-term survival ofalpha-producing gastric cancer.Objective: AFP positive gastric cancer has been regarded as a specialsubtype of gastric cancer. Many cases of AFP positive gastric cancer has beenreported.However, the specific clinical and pathological features and prognosticfactors is not exhaustive. In this retrospective study, we reviewed theclinicopathologic findings and surgical results of45Chinese patients with AFPpositive gastric cancer in a single center. Analysis of histological andimmunohistochemical features, and clarify the clinicopathological characteristics and prognostic features.Methods: The Gastrointestinal Surgery Department of First Hospital ofJilin University had1237cases of primary gastric cancer patients confirmed bypathology underwent surgery from2009-1-1to2012-12-31,651cases ofpatients examined the preoperative serological AFP,17cases of hepatitis,cirrhosis and other excluded in accordance with the exclusion criteria. Theremaining634cases were divided into two groups: AFP-positive group, whichcontains45cases of elevated serum AFP; AFP-negative group, contains589cases of preoperative the serological AFP in the normal range. The AFPpositive group, all of the cases both have HE staining andimmunohistochemical staining to determine its histological type and detectionof AFP expression in primary gastric carcinoma and metastatic lymph nodes.Record the two groups of patients’ gender, age, preoperative AFP level,histological type, degree of differentiation, tumor location, TNM stage,vascular nerve tumor invasion, lymph node metastasis, liver metastasis, andpatients were followed-up and analysis of the clinical and pathological featuresand prognostic factors.Application SPSS20.0software for statistical analysisusing the chi-square test and Fisher exact test of the two sets of data the samefactors. Survival calculated using the Kaplan-Meier survival curves using thelog-rank test, analysis of independent risk factors affecting survival by COXmethod, P <0.05was statistically significant. TNM stage, the Association forInternational Cancer (AJCC)6th edition TNM staging standards. Analysis ofthe percentage of AFP immunohistochemical staining cells, using Image Plus6.0software for analysis.Results:Serological AFP positive and negative groups of patients withAFP levels were (118.263±40.36) mg/L and (2.758±0.053) mg/L (P <0.05).The positive serological AFP Group29cases immunohistochemistry stainingpositive,immunohistochemical staining proportion was64.4%. AFP AFP positive gastric primary tumor and metastatic lymph nodes on the expressionwas different site for the coloration of immunohistochemical staining in thecytoplasm of gastric cancer cells. Which according to the degree of staining ofAFP, divided into four groups:-(16cases);+(14cases);++(7cases);+++(8cases).The positive serological AFP cases were divided into2groups inaccordance with its AFP value:... |
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