title: [Clinicopathological characteristics and prognosis of alpha-fetoprotein producing gastric cancer].
abstract: OBJECTIVE
  Several studies reported a subgroup of gastric cancer patients showing elevated serum alpha-fetoprotein (AFP) at the time of diagnosis. We investigated the clinicopathological characteristics and prognostic factors of AFP producing gastric cancer (AFPPGC) by comparing with AFP non-producing gastric cancer (AFPNPGC).
  
  
  METHODS
  A total of 909 patients were diagnosed with gastric cancer from January 2005 to March 2013 at Gyeongsang National University Hospital and their AFP levels were measured at the time of diagnosis. After excluding 138 patients with underlying liver diseases, 34 patients with elevated serum AFP level over 10 mg/mL were assigned to AFPPGC group and the remaining 737 patients with serum level of AFP below 10 ng/mL were assigned to AFPNPGC group.
  
  
  RESULTS
  The median survival length was shorter in AFPPGC group than AFPNPGC group (18.3 ± 25.5 months vs. 30.0 ± 22.0 months, p=0.004). The incidence of liver metastasis (47.1% vs. 3.3%, p<0.001) and lymph node metastasis (91.2% vs. 31.6%, p<0.001) was significantly higher in AFPPGC group. The probability of encountering metachronous liver metastasis after the operation was higher in AFPPGC group (44.4% vs. 2.0%, p<0.001). Multivariate analysis revealed that patients in the AFPPGC group who received chemotherapy (p=0.037) or underwent operation (p=0.001) had a better survival rate.
  
  
  CONCLUSIONS
  AFPPGC behaves more aggressively and shows a worse prognosis. Therefore, serum AFP level should be routinely checked in all patients diagnosed with gastric cancer.
authors.affiliation: Department of Internal Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 660-702, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lew
authors.forename: Woon Tae
authors.initials: WT
authors.lastname: Jung
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Min
authors.forename: Chang Yoon
authors.initials: CY
authors.lastname: Ha
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Tae Hyo
authors.initials: TH
authors.lastname: Kim
authors.forename: Gyung Hyuck
authors.initials: GH
authors.lastname: Ko
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012907:Smoking; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000509:alpha-Fetoproteins