Comparison between the clinicopathologic features of AFP-positive and AFP-negative gastric cancers.

We compared 27 cases of alpha-fetoprotein (AFP)-positive gastric cancer with 478 cases of AFP-negative gastric cancer in our department. The incidences of AFP-positive gastric cancer were 5.4% (27/505), 7.2% (23/218), and 2.1% (4/187) for overall, advanced, and early cases of gastric cancer, respectively. Sex, age distribution, pathologic type, and serum carcinoembryonic antigen levels were similar between these two groups. Borrmann III type cancer, lymph node metastasis, lymphatic and venous microinvasion of the gastric wall, and incidence of synchronous and metachronous liver metastasis occurred more often in the AFP-positive group. It was suspected that the character of early venous invasion contributed to the high incidence of liver metastasis. Liver metastasis occurred in 72% of AFP-positive patients, all of whom died within 2 yr. Long-term survival of the AFP-positive group was worse than that of the negative group. The 1-, 3-, 5-, and 7-yr survival rates of both groups were 38.7%, 11.6%, 11.6%, 11.6%, and 71.3%, 57.8%, 52.8%, 49.6%, respectively (p less than 0.001).