Alpha-fetoprotein (AFP) elevation gastric adenocarcinoma and importance of AFP change in tumor response evaluation.

Mehmet Emin Kalender,Harun Arslan,Mehmet Ali Kaplan,Didem Tastekin,Ali Murat Tatli,Zuhat Urakci

doi:10.7314/apjcp.2015.16.5.2003

Mehmet Emin Kalender, Harun Arslan + Show 4 more

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https://doi.org/10.7314/apjcp.2015.16.5.2003

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Abstract

Elevated serum alpha-fetoprotein (AFP) levels in adults are considered abnormal. This parameter is used mostly in the diagnosis and follow-up of hepatocellular carcinomas and yolk sac tumors. Among the other rare tumors accompanied with elevated serum AFP levels, gastric cancer is the most common. In this study, we evaluated the follow-up and comparison of the treatment and marker response of patients with metastatic gastric cancer who had elevated serum AFP levels. We performed a retrospective study, including all consecutive patients with advanced gastric cancer, who received systemic chemotherapy with elevated AFP level. Seventeen metastatic gastric cancer patients with elevated AFP levels at the time of diagnosis were evaluated. Fourteen (82.4%) were males and three (17.6%) were females. The primary tumor localization was the gastric body in 8 (76.4%), cardia in 7 (41.2%), and antrum in 2 (11.8%). Hepatic metastasis was observed in 13 (76.4%) at the time of diagnosis. When the relationship of AFP levels and carcinoembryonic antigen (CEA) response of the patients with their radiologic responses was evaluated, it was found that the radiologic response was compatible with AFP response in 16 (94.1%) patients and with CEA response in 12 (70.6%); however, in 5 (29.4%) patients no accordance was observed between radiological and CEA responses. Follow-up of AFP levels in metastatic gastric cancer patients with elevated AFP levels may allow prediction of early treatment response and could be more useful than the CEA marker for follow-up in response evaluation.

Highlights

Elevated serum alpha-fetoprotein (AFP) levels are often detected as a product of fetal liver, yolk sac, and some fetal gastrointestinal cells and decrease rapidly after birth (Gitlin et al, 1972)
We retrospectively reviewed the files of the patients diagnosed with metastatic gastric carcinoma, who received chemotherapy
Investigation of the medical files and electronic records of metastatic gastric cancer patients yielded that AFP values of 89 patients were asked for at the time of diagnosis, and 17 (19.1%) of them were determined to have elevated AFP levels

Summary

Introduction

Elevated serum alpha-fetoprotein (AFP) levels are often detected as a product of fetal liver, yolk sac, and some fetal gastrointestinal cells and decrease rapidly after birth (Gitlin et al, 1972). Among adults elevated AFP levels are often considered abnormal It is generally used as a marker in the diagnosis and follow-up of hepatocellular carcinomas and yolk sac tumors. Bourreille et al, (1970 ) reported the first case of gastric cancer with liver metastasis and elevated AFP levels. Elevated serum alpha-fetoprotein (AFP) levels in adults are considered abnormal. This parameter is used mostly in the diagnosis and follow-up of hepatocellular carcinomas and yolk sac tumors. We evaluated the follow-up and comparison of the treatment and marker response of patients with metastatic gastric cancer who had elevated serum AFP levels. Results: Seventeen metastatic gastric cancer patients with elevated AFP levels at the time of diagnosis were evaluated. Conclusions: Followup of AFP levels in metastatic gastric cancer patients with elevated AFP levels may allow prediction of early treatment response and could be more useful than the CEA marker for follow-up in response evaluation

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