The Analysis Of The Clinicopathological Characteristics And Prognosis Of Serum Alpha-fetoprotein-producing Gastric Cancer

Background and Objective:Alpha-fetoprotein-producing gastric cancer is a rare type of gastric carcinoma, which has its unique clinicopathological features and poorer prognosis. At present, there is still a lack of understanding about this disease. The current study aimed to summarize and discuss the clinicopathological and prognostic features of this disease.Methods:A total of1396cases of gastric cancer in Shandong University Qilu Hospital from2002to2007were retrospectively reviewed. Patients were divided into two groups:90serum AFP-positive patients and1306serum AFP-negative patients. The relationship between serum AFP with clinicopathological factors, survival rate, prognosis and liver metastasis were analyzed.Results:There were90AFP-producing gastric cancer which accounting for6.45%of the gastric cancer of the corresponding time period. There was bigger tumor size, more T3and T4invasion (82.2%vs.69.2%), higher incidence of lymph node metastasis(80%vs.60.2%)and liver metastasis(6.67%vs.1.68%),later clinical stage in the AFP-positive group than in the AFP-negative group. The1,3,5year-overall survival(OS) rate in AFP-positive group were52.2%,31.1%,20%while those in AFP-negative group were82.5%,59.9%,48.8%. And the1,3,5year-disease free survival(DFS) rate in AFP-positive group were47.8%,24.4%,15.6%while those in AFP-negative group were77.5%,54.8%,44.3%. The AFP-positive group had a shorter median time period than the AFP-negative group when liver metastasis happened (5months vs.11months). AFP-positive group had a poorer prognosis than AFP-negative group. Multivariate analysis revealed that AFP-positivity was an independent prognostic factor of gastric cancer.Conclusion:Serum AFP-producing gastric cancer was higher malignancy, it was deeper in invasion and later in clinical stage, it was easier to metastasize to lymph nodes and liver, it had low survival rate and poor prognosis. Serum AFP is a clinically useful maker in predicting the prognosis and liver metastasis of patients with gastric cancer.