产甲胎蛋白胃癌2例报道及文献复习

    Alpha-fetoprotein-producing gastric carcinoma: A report of 2 cases and review of the literature

    • 摘要: 目的: 旨在加深对产甲胎蛋白胃癌(alpha-fetopro tein-producing gastric carcinoma,AFPGC)的诊断、治疗及预后的认识。方法: 回顾性复习2001年11月~2002年6月87例血清甲胎蛋白(AFP)升高的住院患者病历资料,对其中诊断为胃癌患者的手术标本进行苏木精-伊红(HE)染色及免疫组化染色。总结有关资料并复习相关文献。结果: 血清A FP高于正常水平的患者中,2例病理诊断为胃肝样腺癌。AFP、癌胚抗原(CEA)、α1-抗胰蛋白酶(α1-AT)、α1-抗胰糜蛋白酶(α1-ACT)等免疫表型均呈阳性。常规化疗不能控制疾病进展,2者均出现肝转移。结论: AFPGC具有高度侵袭性,易出现肝转移,预后差。治疗首选胃癌根治术,术后推荐使用以丝裂霉素、伊立替康等为主的方案行辅助化疗,但仍有待发现更新的AFPGC综合治疗模式。

       

      Abstract: Objective: To explore diagnosis,therapy,and prognosis of alpha-fetoprotein-producing gastric carcinoma (AFPGC).Methods: The data of 87 cases,who had been treated in our hospital and whose level of serum AFP was higher than normal,were reviewed retrospectively.The samples of the gastric cancer patients were examined by means of HE and immunohistochemistry staining.Results: Among the patients whose serum AFP levels were higher than normal,2 were diagnosed as hepatoid adenocarcinoma of the stomach.Their immunophenotypes were positive,for AFP,CEA,α1-AT,and α1-ACT.The routine chemotherapy couldn't control the progress of the disease.Both of them were reported liver metastases.Conclusions: AFPGC have aggressive behavior and its clinical or biological features are quite different from the common AFP-negative gastric cancers.AFPGC is at high risk of liver metastasis,and its prognosis is poor.Curative gastrectomy is the primary choice of treatment.Regimens of adjuvant chemotherapy including mitomycin and irinotecan are recommended,but the development of a novel multi modal therapy against AFPGC is needed.

       

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