Tomiyama K, Takahashi M, Fujii T, Kunisue H, Kanaya Y, Maruyama S, Yokoyama N, Shimizu N, Soda M
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
J Int Med Res. 2006 Jan-Feb;34(1):109-14. doi: 10.1177/147323000603400114.
We report an extremely rare case of recurrent alpha-fetoprotein (AFP)-producing gastric cancer without re-elevation of serum AFP. The patient was a 78-year-old woman with AFP-producing gastric cancer, a rare type of gastric adenocarcinoma. A Borrmann III gastric tumour was surgically resected and AFP-producing gastric cancer was diagnosed based on high levels of serum AFP (705.44 ng/ml) and immunohistochemical examination of the tumour. The serum AFP level decreased to the normal range after resection without any sign of recurrence by imaging, but the patient developed local recurrence of the cancer and died 13 months after surgery. No re-elevation of serum AFP levels was observed after recurrence. Although serum AFP levels are believed to be useful for follow-up in the post-operative period, the possibility that serum AFP levels do not always correlate with the extent of the cancer should be kept in mind.
我们报告了一例极为罕见的复发性产甲胎蛋白(AFP)胃癌病例,其血清AFP未再次升高。患者为一名78岁女性,患有产AFP胃癌,这是一种罕见的胃腺癌类型。对Borrmann III型胃肿瘤进行了手术切除,并根据血清AFP高水平(705.44 ng/ml)及肿瘤的免疫组化检查诊断为产AFP胃癌。切除术后血清AFP水平降至正常范围,影像学检查未发现任何复发迹象,但患者出现了癌症局部复发,并在术后13个月死亡。复发后未观察到血清AFP水平再次升高。尽管血清AFP水平被认为对术后随访有用,但应牢记血清AFP水平并不总是与癌症范围相关的可能性。