Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis

Nagai, Eishi; Ueyama, Toshihiko; Yao, Takashi; Tsuneyoshi, Masazumi

doi:10.1002/1097-0142(19930915)72:6<1827::aid-cncr2820720606>3.0.co;2-8

Cited by 197 publications

(187 citation statements)

References 18 publications

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“…toyoda et al reported that it is difficult to determine whether an endometrial tumor produces AFP solely on the basis of the morphological features of the tumor (9). nagai et al reported cases of Hcs and AFP-positive adenocarcinomas without heparoid features (APc) of the stomach (16). the incidence of venous invasion in Hc was higher than that of APC.…”

Section: Discussionmentioning

confidence: 99%

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component

Kodama

Seki²,

Yanai³

et al. 2010

Oncology Letters

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Abstract. endometrial carcinomas producing α-fetoprotein (AFP) are extremely rare. We report a case of AFP-producing, grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. A 59-year-old multiparous woman presented with abdominal swelling. the serum level of AFP was 1292.8 ng/ml. Magnetic resonance images of the pelvis showed a markedly enlarged uterus, with a tumor growing exophytically within the endometrial cavity. total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. the histopathological examination demonstrated a stage IIA, grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. the endometrioid adenocarcinoma cells were partly positive for AFP immunoreactivity. the patient received adjuvant chemotherapy and was diseasefree 60 months after the operation. This case confirms the existence of AFP-producing endometrioid adenocarcinomas without hepatoid features.

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Section: Discussionmentioning

confidence: 99%

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component

Kodama

Seki²,

Yanai³

et al. 2010

Oncology Letters

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“…Numerous studies have described the histological features of AFP-GC (20,(27)(28)(29). In 1981, Kodama et al described two histological types of AFP-GC based on immunohistochemical staining, consisting of a medullary type characterized by polygonal cells arranged in solid nests or sheets, and a well-differentiated papillary or tubular type, with clear cytoplasm (27).…”

Section: Discussionmentioning

confidence: 99%

“…To discriminate between non-hepatoid adenocarcinoma and hepatoid adenocarcinoma of the stomach, the measurement of AFP isoforms is also useful, and hepatoid adenocarcinoma of the stomach demonstrates a liver-type binding pattern with the lectin concanavalin A (29). Nagai et al proposed a novel definition, that the diagnosis of AFP-GC may be based on characteristic histological features (20).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of AFP-GC in all gastric carcinoma ranges between 1.3-15.0% (15-19). Nagai et al proposed that the defining diagnosis of AFP-GC may be based on the recognition of characteristic histological features (20). AFP-GC may be divided into two subtypes, consisting of AFP-producing non-hepatoid adenocarcinoma and hepatoid adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

“…AFP-GC may be divided into two subtypes, consisting of AFP-producing non-hepatoid adenocarcinoma and hepatoid adenocarcinoma. AFP-GC is usually diagnosed in the advanced stages of disease and demonstrates a poor prognosis (20)(21)(22). In patients exhibiting serum AFP levels of >300 ng/ml, the 1-, 3-, and 5-year survival rates are 15.4, 7.7%, and 0%, respectively.…”

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confidence: 99%

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α-fetoprotein-producing gastric carcinoma: A case report of a rare subtype and literature review

Sun

et al. 2016

Oncology Letters

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Abstract. α-fetoprotein (AFP)-producing gastric carcinoma is a rare type of gastric cancer, and the characteristics have not yet been fully elucidated. The present study reports the case of a patient with this type of gastric cancer. A 66-year-old male was referred to the Department of Gastrointestinal Surgery, Qianfoshan Hospital, Shandong University (Jinan, China) with a 20-day history of retrosternal pain. A computed tomography (CT) scan revealed a thickening of the wall of the cardia and massive lymph node swelling in the region of the lesser curvature of the stomach. A laboratory investigation revealed that the serum AFP levels of the patient were elevated to 46.49 ng/ml (normal level, <12.00 ng/ml), and the serum carcinoembryonic antigen (CEA) levels were 382.22 ng/ml (normal range, <5.00 ng/ml). An endoscopy revealed an elevated tumor and AFP-producing gastric cancer was diagnosed. As the tumor was surgically unresectable, the patient received systemic adjuvant chemotherapy [consisting of 1 cycle of oxaliplatin (150 mg; day 1)-fluorouracil(1.0 g; days 2-6)-calcium folinate (0.3 g; days 2-6), 4 cycles of paclitaxel (80 mg; day 1 and 8, repeated day 21) and capecitabine (1,000 g/m 2 , twice daily; days 1-14, repeated day 21), and 2 cycles of oxaliplatin (130 mg/m 2 ; day 1, repeated day 21) and S-1 (100 mg/d; day 1-day 14; repeated day 21)]. During the chemotherapy intermission, the patient experienced partial remission; the serum AFP levels remained between 44.5 and 32.7 ng/ml, and serum CEA levels decreased to a normal level. The CT scan revealed that the enlarged lymph nodes of the patient had decreased in size. During the preoperative examinations, an abdominal CT scan revealed no metastasis to the liver. A radical gastrectomy was performed on October 20, 2014. Additionally, the tumor did not demonstrate the diffusion of AFP. The histopathological examination revealed a poorly differentiated adenocarcinoma, with local and neuroendocrine differentiation and no hepatoid features. According to these histopathological findings, the tumor was diagnosed as AFP-producing non-hepatoid adenocarcinoma of the stomach. The patient was treated with systemic immunity-enhancing therapy and has been free of recurrence for 2 months. The present study describes a rare case of AFP-producing non-hepatoid adenocarcinoma of the stomach, with a review of the literature and an investigation of the clinical features. Introductionα-fetoprotein (AFP) is an oncofetal glycoprotein that is mainly produced by the yolk sac and liver during fetal development, and to a lesser extent, in the fetal gastrointestinal tract (1,2). The greatest serum AFP levels are observed between 12-15 weeks after birth, which decrease to normal adult levels subsequent to approximately one year (3,4). AFP is detected in the serum of adults with hepatocellular carcinoma, yolk sac tumors and noncancerous liver disease (2-6). Rising AFP levels may also be detected in the malignant tumors of various organs, including the stomach, lung, pancreas, colon, bladder ...

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Assessment of Clinicopathological Characteristics and Development of an Individualized Prognostic Model for Patients With Hepatoid Adenocarcinoma of the Stomach

Wang

Hong

et al. 2021

JAMA Netw Open

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IMPORTANCEFew studies have examined the clinicopathological characteristics and prognoses of patients with hepatoid adenocarcinoma of the stomach (HAS). OBJECTIVE To explore the clinicopathological characteristics and prognoses of patients with HAS and develop a nomogram to predict overall survival (OS). DESIGN, SETTING, AND PARTICIPANTS This prognostic study involved a retrospective analysis of data from 315 patients who received a diagnosis of primary HAS between April 1, 2004, and December 31, 2019, at 14 centers in China. MAIN OUTCOMES AND MEASURES OS and prognostic factors. Patients were randomly assigned to a derivation cohort (n = 220) and a validation cohort (n = 95). A nomogram was developed based on independent prognostic factors identified through a multivariable Cox mixed-effects model. RESULTS Among 315 patients with HAS (mean [SD] age, 61.9 [10.2] years; 240 men [76.2%]), 137patients had simple HAS (defined as the presence of histologically contained hepatoid differentiation areas only), and 178 patients had mixed HAS (defined as the presence of hepatoid differentiation areas plus common adenocarcinoma areas). Patients with simple HAS had a higher median preoperative α-fetoprotein level than those with mixed HAS (195.9 ng/mL vs 48.9 ng/mL, respectively; P < .001) and a higher rate of preoperative liver metastasis (23 of 137 patients [16.8%] vs 11 of 178 patients [6.2%]; P = .003). The 3-year OS rates of patients with simple vs mixed HAS were comparable (56.0% vs 60.0%; log-rank P = .98). A multivariable Cox analysis of the derivation cohort found that the presence of perineural invasion (hazard ratio [HR], 2.13; 95% CI,

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Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis

Cited by 197 publications

References 18 publications

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component

α-fetoprotein-producing gastric carcinoma: A case report of a rare subtype and literature review

Assessment of Clinicopathological Characteristics and Development of an Individualized Prognostic Model for Patients With Hepatoid Adenocarcinoma of the Stomach

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