Clinicopathologic Features Of AFP-positive Gastric Cancer

Objective To investigate the clinical and pathological features of the AFP-positive gastric cancer(AFPGC), and to explore the relationship and difference between the AFP-positive gastric cancer and gastric cancer with normal AFP, hepatocellular carcinoma with AFP increased.Methods A total of 44 cases the AFP-positive gastric cancer(serum AFP≥10ug/L) tissues were selected as a test group, the cases of serum AFP≥200ug/L were 30. While collected 30 cases gastric cancer with normal AFP and 30 cases hepatocellular carcinoma with AFP increased(serum AFP≥200ug/L) as two control groups. The three group cases have the same clinical stage basically. The expressions of AFP, hepatocyte growth factor receptor c(c-Met), vascular endothelial growth factors(VEGF), epidermal growth factor receptor(EGFR), human epidermal growth factor receptor 2(HER-2), CD34 were detected by immunohistochemistry(En Vision staining method), and tumor vessel density(MVD) was calculated by marking CD34,then the results were analyzed. The clinicopathologic parameters were recorded accurately: gender, age, highest level of serum AFP, tumor differentiation, tumor stage, tumor location, lymph node metastasis, liver metastasis, Lauren classification, etc. These patients were followed up regularly. The clinical pathological features of AFPGC patient’s were investigated.Results 1 AFPGC clinical characteristics showed that 44 cases of AFP-positive gastric cancer group had lymph node metastasis 86.36%(38/44), hepatic metastasis 54.55%(24/44), intestinal type 36.36%(16/44), diffuse type 56.82%(25/44), mixed type 6.82%(3/44), Diffuse type is the main part. 2 The positive expression rates of c-Met protein in AFPGC, gastric cancer with normal AFP, hepatocellular carcinoma with AFP increased were73.33%(22/30), 70.00%(21/30), 53.33%(16/30), respectively; The positive expression rates of VEGF protein were 76.67%(23/30), 56.67%(17/30), 66.67%(20/30), respectively; The positive expression rates of EGFR protein were 53.33 %(16/30), 40.00 %(12/30), 73.33 %(22/30), respectively. The "++ ~ +++" expression rates of HER-2 in AFPGC, gastric cancer with normal AFP and hepatocellular carcinoma with AFP increased were 38.64%(17/44), 23.33%(7/30),26.67%(7/30), respectively. The MVD values in AFPGC, gastric cancer with normal AFP and hepatocellular carcinoma with AFP increased were 23.03±10.24, 21.92±11.45, 19.43±7.83, respectively. Compared with gastric cancer with normal AFP, AFPGC was significantly higher than the former in the expression of VEGF protein(P <0.05), and they had no significant difference in the expression of c-Met,EGFR,MVD, HER-2(P>0.05); compared with hepatocellular carcinoma with AFP increased, AFPGC was significantly higher than the former in the expression of c-Met protein(P <0.05), and they had no significant difference in the expression of VEGF, EGFR, HER-2 and MVD(P>0.05).Conclusion 1 AFPGC is a special kind of cancer. It is easy to lymph node metastasis and hepatic metastasis. The major part is the diffuse type in Lauren classification. 2 The positive expression rates of VEGF protein in AFPGC were significantly higher than the gastric cancer with normal AFP, The positive expression rates of c-Met protein in AFPGC were significantly higher than the hepatocellular carcinoma with AFP increased. The drug therapy of VEGF-related targets may be beneficial for AFPGC; c-Met inhibitors may be useful for AFPGC.