Novel characteristics of alpha-fetoprotein (AFP)-producing gastric cancer.

Wenhui Sun,De Zhou,Weihua Gong,Bo Hong,Ping Gong,Juntao Chen,Xiaoying Wu,Chen Liu,Baoqing Liu

doi:10.18632/oncotarget.22109

Abstract

BackgroundAlthough serum AFP level is increased in the AFP-producing gastric cancer (GC) patient, AFP-producing GC may become recurrent without re-elevation of serum AFP level. Therefore, novel characteristics of AFP-producing GC such as other biomarkers are to be explored.Results35 AFP-GC and 48 non-AFP-GC patients were included. Our present study revealed that blood type O (15 cases, 42.8%) and A (18 cases, 37.5%) were predominantly observed among AFP-GC and non-AFP-GC patients, respectively. Intriguingly, the least consistently was blood type AB (8.5%, 14.6%). Among AFP-GC patients, pre-operative serum AFP levels were weakly and reversely associated with pre-operative percentage of lymphocytes in the peripheral blood (R2 = 0.1556). The level of alkaline phosphatase (ALP) was highly correlated with the level of lactate dehydrogenase (LDH) (R2 = 0.6682) and CEA (R2 = 0.6813). The level of CEA was moderately correlated with the level of LDH (R2 = 0.3903). By contrast, no any associations between ALP, LDH, CEA, AFP, and peripheral lymphocytes were observed among those 48 non-AFP-GC patients.Materials and MethodsRetrospective analysis was carried out for 2773 inpatients of gastric cancer from January 2012 to November 2016 in the Second Affiliated Hospital of Zhejiang University School of Medicine.ConclusionsThe aggressive biological features of AFP-producing GC are closely associated with abnormality of other tumor biomarkers and decrease of the proportion of peripheral lymphocytes, implying that post-operative increase of peripheral lymphocytes might benefit GC patients. Combined use of multiple biomarkers is of significance in comprehensive evaluation of AFP-producing GC patients and assessment for those with high risk of cancer recurrence.

Highlights

Alpha-fetoprotein (AFP) was firstly detected in the human fetus in 1956, which is normally synthesized in the fetal liver as early as 6 weeks of gestation [1, 2]
The aggressive biological features of AFP-producing gastric cancer (GC) are closely associated with abnormality of other tumor biomarkers and decrease of the proportion of peripheral lymphocytes, implying that post-operative increase of peripheral lymphocytes might benefit GC patients
Combined use of multiple biomarkers is of significance in comprehensive evaluation of AFP-producing GC patients and assessment for those with high risk of cancer recurrence

Summary

Introduction

Alpha-fetoprotein (AFP) was firstly detected in the human fetus in 1956, which is normally synthesized in the fetal liver as early as 6 weeks of gestation [1, 2]. Intensive exploration of optimal therapeutic strategies is required to achieve better patients’ survival [3]. In this present study, thirty-five cases of AFP-producing gastric cancer were retrospectively summarized and intriguingly a couple of characteristics of AFP-producing GC were identified. It was reported that the diagnostic rate for early stage gastric cancer in China is as low (about 10%) as that in the western countries owing to opportunistic screening endoscopy is widely available in rural and urban areas. Most of GC cases in our study were in the advanced stage. Our research findings on AFP-producing GCs are of great value even for the western countries. Novel characteristics of AFP-producing GC such as other biomarkers are to be explored

Methods

Results

Discussion

Conclusion