Department of Abdominal Surgery, Cancer Hospital, Fudan University, Shanghai, PR China.
J Surg Oncol. 2010 Sep 1;102(3):249-55. doi: 10.1002/jso.21624.
There were no comprehensive studies on the clinicopathologic features and prognosis of alpha-protein-producing gastric cancer. The aim of this study was to elucidate the clinicopathologic characteristics and prognostic factors of alpha-fetoprotein (AFP)-producing gastric cancer.
Among 4,426 gastric cancer patients receiving surgery in the Cancer Hospital of Fudan University from 1996 to 2007, there were 111 patients with elevated serum level of AFP preoperatively after excluding chronic hepatitis, hepatocirrhosis, and hepatocellular carcinoma. Primary lesions of 104 patients were stained positively for AFP. The clinicopathologic characteristics and prognostic factors of AFP-producing gastric cancer were analyzed. Additionally, 208 stage-matched AFP-negative gastric cancer patients were selected as control.
There was a significantly higher incidence of vascular invasion, lymph node metastasis, and liver metastasis in AFP-positive group than in the negative group. The overall 5-year survival rates of AFP-positive and negative groups were 28% and 38%, respectively. The AFP-positive group had a significantly poorer survival in comparison to the stage-matched negative group. The independent prognostic factors of AFP-positive group included liver metastasis and pathological stage.
AFP-positive gastric cancer had more aggressive behavior than that of AFP-negative gastric cancer. In addition to surgery, multimodal therapy should be considered.
目前尚无关于产α蛋白胃癌的临床病理特征和预后的全面研究。本研究旨在阐明甲胎蛋白（AFP）阳性胃癌的临床病理特征和预后因素。
在复旦大学附属肿瘤医院 1996 年至 2007 年间接受手术治疗的 4426 例胃癌患者中，排除慢性肝炎、肝硬化和肝细胞癌后，有 111 例患者术前血清 AFP 水平升高。104 例患者的原发灶 AFP 染色阳性。分析 AFP 阳性胃癌的临床病理特征和预后因素。此外，选择 208 例 AFP 阴性胃癌患者作为对照。
AFP 阳性组的血管侵犯、淋巴结转移和肝转移发生率明显高于 AFP 阴性组。AFP 阳性组和阴性组的总体 5 年生存率分别为 28%和 38%。与匹配的阴性组相比，AFP 阳性组的生存明显较差。AFP 阳性组的独立预后因素包括肝转移和病理分期。
AFP 阳性胃癌的侵袭性行为比 AFP 阴性胃癌更为明显。除手术外，还应考虑采用多模式治疗。
