AFP-Producing gastric carcinoma: Multivariate analysis of prognostic factors in 270 patients
AFP-Producing gastric carcinoma: Multivariate analysis of prognostic factors in 270 patients
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DOI：
10.1159/000072332
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发表时间：
2003-01-01
期刊：
影响因子：
3.5
通讯作者：
Kitano, S
中科院分区：
文献类型：
--
作者：
Adachi, Y;Tsuchihashi, J;Kitano, S
原发性胃癌患者血清甲胎蛋白（AFP）有时较高，对产甲胎蛋白胃癌（AGC）的临床病理特征及预后因素的研究尚不全面。为了明确与胃癌切除术后生存相关的变量，我们回顾了胃癌患者的数据，并检查了独立的预后因素。我们研究了1982年6月至2001年3月在日本文献中报道的270例AGC，其中包括1例我们自己的经历。检查临床病理表现，包括血清AFP水平、手术治愈率和疾病分期，并通过多因素分析确定与生存相关的因素。I期15例（6%），II期50例（19%），III期51例（20%），IV期145例（55%）。肿瘤的特征为频繁的浆膜侵袭（75%），淋巴结转移（83%），肝转移（33%），III期或IV期疾病（75%）和无法治愈的手术（48%）。生存受血清AFP水平、肿瘤大小、浆膜浸润、淋巴结转移和肝转移的影响，但独立的预后因素是手术治愈率（治愈vs不可治愈）和疾病分期（I、II vs III、IV）。虽然所有患者的5年生存率和中位生存期分别为22%和14个月，但治愈性胃切除术患者的5年生存率和中位生存期分别为42%和29个月。结果表明，手术治愈率和疾病分期是影响AGC患者生存的重要因素。虽然肿瘤往往是晚期并伴有肝转移，但当I期或II期肿瘤患者进行根治性胃切除术时，可以获得长期生存。版权所有(C) 2003 S. Karger AG，巴塞尔。
Serum alpha-fetoprotein (AFP) is sometimes high in patients with primary gastric carcinoma, and there is no comprehensive study on the clinicopathologic characteristics and prognostic factors of AFP-producing gastric carcinoma (AGC). To clarify the variables associated with the survival after gastrectomy for AGC, we reviewed the data of patients with AGC and examined the independent prognostic factors. We studied 270 cases of AGC reported in the Japanese literature from June 1982 to March 2001, together with 1 patient of our own experience. The clinicopathologic findings, including serum AFP level, operative curability, and stage of the disease were examined, and factors associated with survival were determined by multivariate analysis. There were 15 stage I tumors (6%), 50 stage II tumors (19%), 51 stage III tumors (20%), and 145 stage IV tumors (55%). The tumors were characterized by frequent serosal invasion (75%), lymph node metastasis (83%), liver metastasis (33%), stage III or IV disease (75%), and noncurative operation (48%). The survival was influenced by the serum AFP level, tumor size, serosal invasion, lymph node metastasis, and liver metastasis, but the independent prognostic factors were operative curability (curative vs. noncurative) and stage of the disease (I, II vs. III, IV). Although the 5-year survival rate and median survival period in all patients were 22% and 14 months, respectively, those in patients with curative gastrectomy were 42% and 29 months, respectively. The results indicate that operative curability and stage of the disease are factors associated with the survival of patients with AGC. Although tumors are often advanced and complicated with liver metastases, long-term survival can be achieved when patients with stage I or II tumor undergo curative gastrectomy. Copyright (C) 2003 S. Karger AG, Basel.