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

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.