Abstract
In the present study, we compared patients with gastric carcinoid who were preoperatively positive or negative for serum AFP in order to clarify the characteristic features of AFP-positive gastric carcinoid. The prognosis of AFP-positive gastric carcinoid and the location of AFP in the cancerous focus were also studied. The subjects were 143 patients who underwent surgery for gastric cancer. They were composed of nine with serum AFP levels of 21ng/ml or more (positive cases) and 134 with corresponding levels of 20ng/ml or less (negative cases), and these two groups were compared clinicopathologically. The AFP-positive patients were further divided into those with relatively high AFP levels of 100ng/ml or more and those with relatively low AFP levels of 99ng/ml or less, and the two groups were compared with regard to the prognosis and the location of AFP in cancer cells. Most AFP-positive cancers were located in the A area and were markedly advanced macroscopic types 2 or 3, with a high frequency of hepatic metastasis. The high-level group showed a high probability of hepatic metastasis and a high risk of recurrence of hepatic metastasis. Two cases without hepatic metastasis in the high-level group were found to be AFP-producing cancers. We believe that determination of serum AFP is useful not only for detecting AFP-producing cancer but also for judging the likelihood of recurrence of heptic metastasis.
