Open AccessInfluence of high serum alpha fetoprotein on patients with gastric cancer
Author(s) -
Chen MingYao,
Fang WenLiang,
Huang KuoHung,
Lai YuHsin,
Lin HwaiJeng
Publication year - 2017
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.12050
Subject(s) - medicine , gastroenterology , cancer , incidence (geometry) , lymph node metastasis , lymph node , metastasis , stage (stratigraphy) , paleontology , physics , optics , biology
Summary Backgrounds Patients with alphafetoprotein (AFP)‐producing gastric cancer (AFPGC) have a high incidence of liver metastasis and poor prognosis. However, the clinical manifestation of AFPGC remains controversial. Methods We enrolled patients who, before surgery, had gastric cancer with serum AFP levels of > 100 ng/mL ( n = 30) and of ≦ 20 ng/mL ( n = 1236). Clinical manifestations were compared between these two groups. Results Compared with in the AFP > 100 group, early gastric cancer was more frequent (30.1% vs. 0%) and advanced gastric cancer was less frequent (69.9% vs. 100%) in the AFP ≦ 20 ng/mL group ( p < 0.001). Moreover, the incidence of liver and lymph node metastases was lower in the AFP ≦ 20 ng/mL group than in the AFP > 100 ng/mL group (4.4% vs. 43.3%, p < 0.001 and 60.7% vs. 93.3%, p < 0.001, respectively). More patients had stage IV AFPGC in the AFP > 100 ng/mL group than in the ≦ 20 ng/mL group (66.7% vs 27.1%, p < 0.001). Furthermore, fewer patients underwent curative surgery in the AFP > 100 ng/mL group (6.7% vs 37.9%, p < 0.001). More patients in the AFP > 100 ng/mL group died because of gastric cancer (66.7% vs 27.1%, p < 0.0001). Conclusions Patients with very high serum AFP levels have a high incidence of liver and lymph node metastases and extremely poor prognosis. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.