An analysis of clinicopathological features and prognosis by comparing hepatoid adenocarcinoma of the stomach with AFP-producing gastric cancer.

OBJECTIVE

To investigate the differences between alpha-fetoprotein-producing gastric cancer (AFPPGC) and hepatoid adenocarcinoma of the stomach (HAS), and the clinicopathologic features and prognosis of HAS.

METHODS

From 1996 to 2007, there were 111 patients with elevated serum level of alpha-fetoprotein (AFP) preoperatively in Fudan University Shanghai Cancer Center. Primary lesions of 104 patients were stained positively for AFP. Among these patients, 45 patients were diagnosed as HAS. The clinicopathologic characteristics and prognostic factors of AFPPGC and HAS were analyzed. Additionally, 208 stage-matched AFP-negative gastric cancer patients were selected as control.

RESULTS

Immunohistochemically, the tumor cells were positive for AFP in AFPPGC. Histologically, the polygonal tumor cells were arranged in trabecular fashion or solid nests separated by narrow fibrous stroma composed of sinusoid-like capillaries in HAS. The survival rates of the three groups were statistically different (P < 0.01).

CONCLUSION

AFP-producing gastric cancer and HAS had more aggressive behavior than that of common gastric cancer. The prognosis of HAS was poorer than that of AFPPGC, therefore it should be distinguished from the latter.