| Objective: This present study discusses the Clinicopathologic characteristics and prognostic features and treatment and diagnosis of hepatoid adenocarcinoma of the stomach in our hospital, In order to deepening the understanding of this disease and providing some experience for the disease. Method: The clinical data of 21 hepatoid adenocarcinoma of the stomach that were proven by pathology from January 2006 to January 2014 at the first affiliated hospital of Fujian Medical University were retrospectively collected, observing the postoperative survival time to December 2014. The Kaplan-Meier method was used to estimate clinicopathogical feature were analyzed retrospectively. And we will discuss the integrated use of immunohistochemical index relationship with the prognosis of liver metastasis, etc. Results: Totally, 21 cases were retrieved, that accounted for the same period from 0.32%(21/6500) of the total number of gastric cancer. Inclusion criteria is based on the full backing of the postoperative pathological diagnosis report. There were 18 men and 3 women among 21 patients with ages ranging 28 to 86 years. The average age of the patients was 61.8 years, and the male-to-female ratio was 6:1.In most of these patients,the tumors occurred mainly at the antrum of the stomach, and the serum AFP level of was higher than normal in 52.4% of these patients. The average serum AFP was 149.85ng/ml, Its highest level is 1210ng/ml(Limiting for measurement). In our study, Borrmann type I had a total of 4 cases, Borrmann type II had 8 cases, Borrmann type III had 8 cases, Borrmann type IV had 1 case. Pathology results were differentiated three types, 12 cases were low differentiated cases, 4 cases were low-moderate differentiated and 5 cases were moderate differentiated, Only one patient belonged to early gastric cancer. Among 21 patients, the metastases to the liver appeared in 7 patients, and 16 patients with lymph node metastasis, only 3 cases were not presented. In the postoperative follow-up, there were 3 cases that transfered to the liver, 1 case appeared liver, lung, bone, brain metastases. One case appeared peritoneal metastasis. Six patients were still alive at the moment. The follow-up time started from postoperative time to December 2014. The Clinical characteristics are shown in table 1. By throughing inductiving prognosis statistics of 21 cases, the median survival was 26 months, 15 cases were died, The shortest survival period was 3 months, the longest was 102 months, 1, 2, 3 year over-all survival rate of these patients were 67%、46%、18%. This article described the surgery and chemotherapy treatment results and analysis, and provided some experience for newcomers. For the prognosis, The Log- Rank test was used to identify risk factors for survival in patients with HAS. Those factors included the patient’s age, Gender, Lesion sites, Tumor staging, Liver metastasis, Lymph node metastasis, Serum AFP, Serum CEA, Vascular tumor emboli, immunohistochemical Herpar1, immunohistochemical AFP, immunohistochemical CEA. In the univariate analysis, the results showed liver metastasis and tumor staging were the determinants for survivals in patients with HAS. Conclusion: Hepatoid adenocarcinoma of the stomach had the characteristics of part of the gastric cancer, such as the Middle-aged men occupied the majority、it occurred mainly at the antrum of the stomach, in addition, with elevated serum AFP、liver metastasis、poor prognosis were unique characteristics. The diagnosis of HAS mainly according to the pathological diagnosis,however,we could make clinical diagnosis before it. HAS lacked systemic treatment, it needed further research. Drawing from the result of single factor analysis, liver metastasis and tumor TNM staging were the influence factors of prognosis of HAS. |
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