51例产甲胎蛋白胃癌的临床病理特征和预后  

Clinicopathologic features and prognosis of 51 patients withα-fetoprotein-producing gastric cancer

作　　者：刘晓玲[1] 杨牡丹[1] 高峻[1] 张素珍[1] 郗彦凤[2] 

机构地区：[1]山西省肿瘤医院消化二科,太原030013 [2]山西省肿瘤医院病理科

出　　处：《中华肿瘤杂志》2015年第3期231-234,共4页Chinese Journal of Oncology

摘　　要：目的：分析产甲胎蛋白胃癌（ AFPGC）患者的临床病理特征和预后。方法回顾性分析2005年1月至2007年12月间山西省肿瘤医院消化科收治的51例血清AFP阳性且原发灶免疫组化染色阳性的AFPGC患者（研究组）的资料，并以同期收治的65例血清AFP正常胃癌患者作为对照。对两组胃癌患者的临床病理特征和随访资料进行统计学分析。结果研究组与对照组比较，低分化腺癌明显增多（P＝0．021），肝转移的发生率明显增高（P＝0．001），TNM分期明显增高（P＝0．001）。研究组患者的1年、2年和5年生存率分别为62．7％、27．5％和4．7％，中位生存时间为16个月。对照组患者的1年、2年和5年生存率分别为84．6％、55．4％和16．5％，中位生存时间为30个月。研究组患者的1年、2年和5年生存率以及中位生存时间明显低于对照组患者（ P＜0．001）。研究组患者的血清AFP水平为58．63～12100．00μg／L，其中＜500μg／L 组27例，≥500μg／L组24例，两组患者的AFP免疫组化染色结果差异无统计学意义（P＝0．912）。结论 AFPGC是一种特殊类型的胃癌，恶性程度高，预后差。监测血清AFP水平可以及早发现胃癌患者的病情进展，并给予相应的治疗。Objective To analyze the clinicopathologic features and prognosis of α-fetoprotein （ AFP）-producing gastric cancers （ AFPGC） .Methods Fifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions （ study group） and sixty-five gastric cancer cases with normal AFP level （ control group） treated in our department from January 2005 to December 2007 were included in this study.Their clinicopathologic features and follow-up data were statistically analyzed. Results Compared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma （P=0.021） and liver metastasis （P=0.001） than that in the control group.The TNM stages in the study group were significantly higher than those in the control group （P=0.001）.The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5%and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group （P〈0.001 for all）.The serum AFP levels in the study group ranged from 58.63μg/L to 12 100.00μg/L, and could be classified into two groups：27 cases 〈500μg/L, and 24 cases≥500μg/L.There was no significant difference of the immunohistochemical staining results between the two subgroups （ P =0.912） .Conclusions AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis.Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.

关 键 词：胃肿瘤 甲胎蛋白 免疫组织化学 预后 

分 类 号：R735.2[医药卫生—肿瘤]