Sato Y, Sekine T, Ohwada S
Abdominal Surgery Clinic, Saitama Cancer Center Hospital, Japan.
J Surg Oncol. 1994 Apr;55(4):265-8. doi: 10.1002/jso.2930550414.
alpha-fetoprotein (AFP) production by rectal cancer is very rare. In the English literature there are only a few reported cases in which serum AFP level was > 1,000 ng/ml. A 43-year-old Japanese man with rectal cancer and liver metastases had a high serum AFP level (941 ng/ml) when first evaluated. Three weeks later, the serum AFP level was extremely elevated (7,060 ng/ml). He underwent abdominoperineal excision of the rectum and biopsy of liver metastases. The placement of an intrahepatic-arterial infusion catheter into the proper hepatic artery via the right gastroepiploic artery was also performed. Immunohistochemically, AFP-positive cells were identified in both the rectal and liver tumors. Nine days postoperatively, the serum AFP level was 2,000 ng/ml. In spite of intensive chemoimmunotherapy, serum AFP level was increased and 14 weeks after surgery was extremely elevated (267,300 ng/ml). The patient succumbed to cancer 3 months after surgery. To our knowledge, this is the first case of an AFP-producing rectal cancer in which AFP doubling time could be calculated as 12.8 days.
直肠癌产生甲胎蛋白（AFP）的情况极为罕见。在英文文献中，仅有少数几例报告血清AFP水平>1000 ng/ml的病例。一名43岁患有直肠癌并伴有肝转移的日本男性在初次评估时血清AFP水平较高（941 ng/ml）。三周后，血清AFP水平急剧升高（7060 ng/ml）。他接受了直肠腹会阴切除术及肝转移灶活检，还通过胃网膜右动脉将肝内动脉灌注导管置入肝固有动脉。免疫组化显示，在直肠肿瘤和肝肿瘤中均发现了AFP阳性细胞。术后九天，血清AFP水平为2000 ng/ml。尽管进行了强化化学免疫治疗，血清AFP水平仍持续升高，术后14周时极度升高（267300 ng/ml）。该患者术后3个月死于癌症。据我们所知，这是首例能够计算出AFP倍增时间为12.8天的产生AFP的直肠癌病例。
