Alpha-fetoprotein-producing gastric cancer

We measured the sero-positivity rate of serum α-fetoprotein (αFP) of gastric cancer patients by ELISA assay; forty-two curatively resected patients, 14 palliatively resected patients, 8 who received explo-laparotomy or bypass surgery and 18 patients with systemic metastasis. The sero-positive rate was 9.8% (8/82) and the positivity increased with cancer progression. Sex, age and pathological type were similar between αFP-positive and - negative patients. The overall synchronous hepatic metastasis rates in αFP- positive and αFP-negative groups were 37.5% (3/8) and 12.2% (9/74), respectively (p=0.08). The predictability of synchronous liver metastasis in eight αFP-positive patients were as follows: 37.5% of total patients (3/8), 50.0% (3/6) of unresectable patients, and 60.0% (3/5) of patients with systemic metastasis. In three αFP-positive patient with liver metastasis, all the hepatic lesions were intrahepatic and multiple, while in αFP- negative patients, 67% (6/9) of the hepatic lesions was single intrahepatic lesion or surface nodule. The predictability of both synchronous and metachronous liver metastasis in αFP-positive gastric cancer patients was 75%. These findings suggested that, in advanced stomach cancer patients, especially in stage IV, αFP can be used in predicting liver metastasis during follow-up.