Zuo C T, Ju Q
Department of General Surgery, The Third People's Hospital of Qingdao, Qingdao, China -
Minerva Med. 2015 Aug;106(4):185-91.
The aim of this analysis was to investigate the clinical characteristics and prognosis of patients with serum alpha-fetoproteinpositive gastric cancer (AFPGC) in order to improve the diagnosis and treatment.
A retrospective analysis was performed on the clinical characteristics and survival data of patients with gastric cancer in our hospital between March 2007 and September 2012, to compare the clinical characteristics of patients with serum AFPGC to those of patients with serum AFP-negative gastric cancer. A Cox regression model was used to explore the prognosis factors for gastric cancer.
The 106 patients with serum AFPGC accounted for 8.5% (106/1253) of all the patients during the same period. There were poorer differentiation (64.2% vs. 54.0%), later clinical stage (83.1% vs. 48.6% at III+IV stage), larger tumor volume (78.3% vs. 57.9% with diameter>5 cm), and higher incidence of liver metastases (14.2% vs. 2.8%) and lymph node metastasis (76.4% vs. 52.7%) in patients with serum AFPGC than in those with serum AFP-negative gastric cancer (P<0.05). The 1-, 3-, and 5-year survival rates in patients with serum AFPGC were 52.8%, 31.3%, and 19.8%, respectively, with a median survival time of 14 months, and those in patients with serum alpha-fetoprotein-negative gastric cancer were 78.3%, 54.8%, and 36.8%, respectively, with a median survival time of 40 months. Multivariate Cox regression analysis showed that serum AFP positive (RR=2.70, 95% CI:1.50~4.87) was one of the risk factors of prognosis for patients with gastric cancer.
It is more malignant in patients with serum AFPGC than in those with serum alpha-fetoprotein-negative gastric cancer. There are later clinical stage, poorer differentiation, larger tumor volume, and higher incidence of metastasis to the liver and lymph nodes in patients with serum AFPGC, with low survival rate and poor prognosis.
本分析旨在研究血清甲胎蛋白阳性胃癌（AFPGC）患者的临床特征及预后，以改善诊断与治疗。
对2007年3月至2012年9月我院胃癌患者的临床特征及生存数据进行回顾性分析，比较血清AFPGC患者与血清甲胎蛋白阴性胃癌患者的临床特征。采用Cox回归模型探讨胃癌的预后因素。
106例血清AFPGC患者占同期所有患者的8.5%（106/1253）。血清AFPGC患者的分化程度较差（64.2%对54.0%）、临床分期较晚（Ⅲ+Ⅳ期为83.1%对48.6%）、肿瘤体积较大（直径>5 cm者为78.3%对57.9%）、肝转移发生率较高（14.2%对2.8%）及淋巴结转移发生率较高（76.4%对52.7%），均高于血清甲胎蛋白阴性胃癌患者（P<0.05）。血清AFPGC患者的1年、3年和5年生存率分别为52.8%、31.3%和19.8%，中位生存时间为14个月；血清甲胎蛋白阴性胃癌患者的1年、3年和5年生存率分别为78.3%、54.8%和36.8%，中位生存时间为40个月。多因素Cox回归分析显示，血清甲胎蛋白阳性（RR=2.70，95%CI：1.50~4.87）是胃癌患者预后的危险因素之一。
血清AFPGC患者比血清甲胎蛋白阴性胃癌患者的恶性程度更高。血清AFPGC患者临床分期较晚、分化较差、肿瘤体积较大、肝及淋巴结转移发生率较高，生存率低且预后差。
