Clinical Features And Prognostic Factors Of Alpha-fetoprotein-positive Gastric Cancers In 43 Tibetan Plateau Patients

Objetive To investigate the clinical characteristics,prognosis and influencing factors of this type of gastric cancer subtype in Tibetan Tibetan Plateau patients,we reviewed the clinicopathologic findings of 43 Chinese Tibetans patients in the plateau area of Tibet with AFP positive gastric cancer in a single center by a retrospective study.This study would like to provide reference for clinical diagnosis and treatment of gastric cancer subtypes for this region.Methods A retrospective analysis of 43 cases of AFP-positive gastric cancer in the newly admitted consecutive cases,who admitted to the hospital from the Department of Oncology in the People's Hospital of Tibet University for gastric cancer,and from 2013.9.1 to 2016.9.1 was conducted as the study group.At the same time,277 cases of serum AFP-negative gastric cancer were selected as the control group.The clinical characteristics of the two groups of patients,relevant treatment methods and survival data were followed,and the spss software was used for statistical analysis of the general clinical features and prognosis of the data.Results Compared with the serum AFP-negative group,the KPS score in the first diagnosis(P value is 0.030),but clinical TNM clinical stage is higher(P value is 0.008),and the lymph node metastasis rate,hepatic metastasis rate,and digestive complications occurred.The ratio is higher(P values are 0.027,0.005,and 0.003,respectively);However,there was no significant difference in baseline characteristics such as sex,age of onset,newly diagnosed body mass index,and clinical features such as primary site,differentiation,extrahepatic metastases,surgical treatment,and drug treatment types(P>0.05);The overall clinical stage reached IIIC stage and above was 55.63%(178 cases);of the two groups,some were immunohistochemically examined and the results of the two cases with VEGF and Ki-67 were compared,and the AFP positive group was found.The positive rate of the middle case was higher than that of the control group,but the difference was not statistically significant(P>0.05);The survival analysis showed that the overall survival(OS)in the serum AFP positive group was significantly lower than that in the negative group,and the difference in overall survival was statistically significant(Kaplan-Meier analysis,P=0.006,P<0.05).The 1-,2-,and 3-year survival rates of AFPGC and control groups were 34.06%,18.92%,9.46%,52.75%,35.55%,and 19.89%,respectively.The median survival time was 15.89 months for serum AFP positive group and 25.92 months for serum AFP negative group.Among patients with serum AFP-positive gastric cancer,serum AFP levels before treatment with liver metastases were significantly higher than those without metastasis(Wilcoxon rank-sum test,P<0.001);Kaplan-Meier survival function curves showed that serum AFP-positive gastric cancer cases were treated The pre-serum AFP value was less than 101.9 IU/mL group,and the OS was significantly higher than the 101.9 IU/mL group,the difference was statistically significant(P= 0.012,P<0.05);Survival analysis of surgically treated cases found that the survival function curves of the postoperative AFPGC group and the control group showed that there was no significant difference in the overall OS between the two groups(Kaplan-Meier analysis,P=0.160,P>0.05).COX multivariate analysis showed significant significance(P<0.05 for overall model test),Extrahepatic organ metastasis,late clinical TNM stage,and no surgical treatment were independent risk factors for prognosis(P values were 0.015 and 0.003,respectively,P<0.05).Conclusion 1.The first clinical staging of Tibetan cancer in this study was generally late.It is necessary to increase the prevention and control of gastric cancer and the screening of early gastric cancer.Compared with serum AFP-negative gastric cancer,the first clinical stage of positive gastric cancer was later,the lymph node metastasis rate,liver metastasis rate were higher,and gastrointestinal complications were more likely to occur.Excluding the increase in AFP caused by liver disease and germ cell tumors,serum AFP may be considered for screening of gastric cancer subtypes.2.The overall survival time of serum AFP positive gastric cancer is shorter.The higher the serum AFP value,the worse the prognosis.The level of serum AFP has a certain clinical value for the prognosis of this type of gastric cancer.