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A Journal on Internal Medicine
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,236
Minerva Medica 2015 Sep 14
An analysis on clinical characteristics and prognosis of patients with serum alpha-fetoprotein-positive gastric cancer
Zuo C. 1, Ju Q. 2 ✉
1 Department of General surgery, The Third People’s Hospital of Qingdao, Licang District of Qingdao City, Qingdao, China
2 The Third People’s Hospital of Qingdao, Licang District of Qingdao City, Qingdao, China
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with serum alpha-fetoprotein-positive gastric cancer (AFPGC) in order to improve the diagnosis and treatment.
METHODS: 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.
RESULTS: 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 > 5cm), 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.
CONCLUSION: 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.