Clinical And Pathological Analysis Of 21 Cases Of Hepatoid Adenocarcinoma Of Stomach

Objective:To investigate the clinical characters,pathological features and treatment of hepatoid adenocarcinoma of stomach.Methods:From May 2005 to May 2017,there were 5221 cases of gastric cancer admitted in the Second Afiliated Hospital of Zhejiang University,school of medicine.Twenty-one patients with pathological diagnosis of hepatoid adenocarcinoma of stomach were reviewed retrospectively.In addition,42 patients with common gastric cancer were randomly selected as the control group.Among them,we excluded patients with neoadjuvant chemotherapy,history of hepatitis,cirrhosis and teratoma.In the end,21 patients with hepatoid adenocarcinoma of stomach were enrolled.Results:Of the 21 patients,19 were male,with a median age of 63 years.Postoperative pathological analysis:stage ? 1 case(4.8%),stage ? 3 cases(14.2%),stage ? 8 cases(38.1%),stage ? 9 cases(42.9%).The most common metastases were lymph nodes(n = 17),followed by liver(n = 7).Among them,the rate of liver metastasis was 7 cases(33.3%),which was higher than that of common gastric cancer in 0 case(0%),and distant metastasis in 10 cases(45.4%),the proportion was higher than that in 0 case(0%)of common gastric cancer.Of the 21 patients with hepatoid adenocarcinoma of stomach,19 patients received preoperative serum alpha fetoprotein(AFP)data,and 7 cases(36.8%)were positive;16 patients had immunohistochemical results,and 13 cases(81.25%)with positive AFP expression in tumor tissues,but 3 cases(18.75%)had no AFP expression.According to the calculation of P value,this study showed that hepatoid adenocarcinoma of stomach was more likely to occur in elderly men.The abnormal serum AFP was higher than the incidence of common gastric cancer,and there was a higher liver metastasis rate and distant metastasis rate.However,there was no significant difference in tumor location,differentiation,lymph node metastasis,serum CEA and CA199(P>0.05).Conclusion:Hepatoid adenocarcinoma of the stomach is common in elderly male patients.Compared with common gastric cancer,the abnormal proportion of serum AFP is high.The level of serum AFP is of great significance in the diagnosis of hepatoid adenocarcinoma of the stomach and it can be one of the important conditions for the diagnosis of this disease.When serum AFP levels are elevated,and imaging findings suggest that gastric and liver tumors exist simultaneously,clinicians should take into account the extremely rare disease of hepatoid adenocarcinoma of the stomach.