Influence of high serum alpha fetoprotein on patients with gastric cancer

Abstract

SummaryBackgroundsPatients 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.MethodsWe 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.ResultsCompared 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).ConclusionsPatients 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.