| Objective To analyze and summarize the clinical and pathological features,treatment methods and prognostic factors of alpha-fetoprotein-producing gastric cancer(AFPGC),and to provide a scientific idea for the individualized effective diagnosis and treatment of AFP-producing gastric cancer.Methods A retrospective analysis of 2354 cases of gastric cancer patients from the First Affiliated Hospital of Shihezi University and Shihezi People's Hospital in Shihezi District from January 2007 to October 1818,excluding hepatitis,cirrhosis,hepatocellular carcinoma and germ cell malignant tumors.After 96 patients with elevated serum AFP,96 patients with elevated AFP were analyzed for clinical pathological information including gender,age,tumor size,stage,tumor type,tumor location,treatment,AFP level and prognosis.100 cases of non-alpha-fetoprotein-containing gastric cancer were collected as a control group for statistical analysis.Results 1.A total of 96 patients with AFPGC with relatively complete case information were collected,accounting for 4% of patients with gastric cancer in the same period.Among 96 patients with AFPGC,66 were male and 30 were female,the ratio was about 2.2:1;35 patients were younger than 60 years old,35 were 60 years old or older;the primary site was 54 patients.For example(56.3%),16 cases(16.7%)were in Tuen Mun and 26 cases(27.0%)in corpus.There was no statistically significant difference(p>0.05)compared with non-AFPGC patients in the control group.2.The pathological types of AFPGC are generally poor,including 78 cases of poorly differentiated adenocarcinoma(accounting for 81.2%);and the stage of AFP gastric cancer is generally relatively late,including 21 cases(27.0%)of stage I-II,stage III there were 40 patients(41.6%)and 35 patients(45.4%).Compared with non-AFPGC patients in the control group,the pathological type and stage of AFPGC patients were significantly worse(p<0.05).3.The rate of liver metastasis in AFPGC patients was 27%(38/96),the rate of lymph node metastasis was 67.7%(65/96),and the rate of metastasis in other sites was 27%(26/96),which was much higher than non-AFPGC(p<0.05).4.Among the 4.96 patients with AFPGC,30 patients(31.2%)had abnormal liver function,slightly more than 19 patients(19%)with non-AFPGC(p<0.05).There were 34 HP-positive patients(35.4%),35 patients with elevated CEA(36.4%),35 patients with CA72-4(36.4%),and 35 patients with fatty liver(36.4%).There were 34 patients(35.4%)with history and 16 patients(16.7%)with alcohol history.There was no statistically significant difference(p>0.05)compared with non-AFPGC patients in the control group.5.The 42 patients with APGGC who underwent radical gastrectomy(43.7%)were much lower than those with non-AFPGC(75%)(p<0.05).Therefore,it can be considered that AFPGC is mostly unsuitable for surgical treatment.6.The 1-,3-,and 5-year survival rates of AFPGC were 64.6%,21.9%,and 7.3%,respectively,which were significantly lower than 83.0%,41%,and 13% of non-AFPGC.7.The level of AFP decline after treatment,clinical stage,liver metastasis and whether surgery were independent factors affecting the prognosis of AFPGC(p<0.05).Conclusion 1.AFPGC is a very rare type of gastric cancer with high malignancy,poor therapeutic effect and poor prognosis.2.AFPGC is highly invasive and is prone to liver metastasis.Surgery is currently the treatment of choice.3.The level of AFP decline after treatment,clinical stage,liver metastasis and whether surgery is an independent factor affecting the prognosis of AFPGC. |
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