Seronegative Alpha-Fetoprotein-Producing Early Gastric Cancer Treated with Endoscopic Mucosal Resection and Additional Surgery

Shoji, Hirokazu; Tanimizu, Masahito; Tsuzuki, Takao; Tsubouchi, Eiji; Hidaka, Shigekazu; Hyodo, Ichinosuke; Tajiri, Hisao

doi:10.2169/internalmedicine.43.926

Cited by 13 publications

(5 citation statements)

References 8 publications

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“…In previous reports, AFPGC was usually associated with a poor prognosis with a high incidence of lymphatic invasion, venous invasion, and synchronous and metachronous liver metastasis[ 23 - 25 ]. Hirasaki et al[ 26 ] studied 24 cases of AFP-producing early gastric cancer and reported that liver metastasis was seen in 2 cases (8.3%) and lymph node metastasis was seen in 18 of 24 cases (75.0%). From these results, they suggested that lymph node metastasis should be generally taken into consideration in AFP-producing early gastric cancer even if lymph node swelling is not seen on diagnostic imaging and that such patients should be under close periodic observation.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

Matsumoto¹,

Ueyama²,

Matsumoto³

et al. 2016

WJG

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AIMTo investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation (GCED).METHODSWe retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer (CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our hospital. GCED was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection rate.RESULTSSix cases (5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases (139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC (66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED (positivity, 83.3%), immunohistochemically.CONCLUSIONEven in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this highly malignant type of cancer.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

Matsumoto¹,

Ueyama²,

Matsumoto³

et al. 2016

WJG

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“…Among these 24 cases, liver metastasis was observed in 2 patients 8 and lymph node metastasis was found in 18 patients 72 , all detected upon diagnosis 8 . Thus, even if gastric hepatoid adenocarcinoma could be detected in the early stage, liver and lymph node metastases may have already occurred [9][10][11][12] .…”

Section: Histopathological Ndingsmentioning

confidence: 99%

Coexistence of Choriocarcinoma and Hepatoid Adenocarcinoma in Early Gastric Cancer

Yoshida

Kunimura

Mori

et al. 2010

Showa Univ J Med Sci

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“…-Fetoprotein (AFP)-producing gastric carcinoma (AFPGC) is a rare and special subtype of gastric cancer (GC) associated with high liver metastasis rate and extremely poor prognosis 1,2 . According to the World Health Organization (WHO) classification of digestive system tumors (5th edition, 2019) 3 , AFPGC is characterized as a rare type of GC with elevated serum AFP levels and positive immunohistochemistry (IHC) staining for AFP, accounting for 1.3-5.4% of GC [4][5][6][7] .…”

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confidence: 99%

Whole-exome sequencing of alpha-fetoprotein producing gastric carcinoma reveals genomic profile and therapeutic targets

et al. 2021

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Alpha-fetoprotein producing gastric carcinoma (AFPGC) is a rare and aggressive subtype of gastric cancer. However, little is known about the genomic features of this disease. We perform whole-exome sequencing analysis of AFPGC, and identify 34 significantly mutated genes. Somatic copy number alterations analysis reveals several significant focal amplifications (e.g. 19q12, 17q12) and focal deletions (e.g. 1p36.11, 9p21.3), and some of these negatively affect the patient prognosis. Comparative analyses reveal that AFPGC has distinct genomic features from gastric cancer of The Cancer Genome Atlas as well as four molecular subtypes. Several frequently altered genes with potential as therapeutic targets are identified in AFPGC. Further analysis reveals that AFPGC with amplification of CCNE1 at 19q12 and/or ERBB2 at 17q12 show poorer survival and more aggressive. Subsequently, based on our established patient-derived xenograft models for AFPGC, translational research is performed and the therapeutic value of targeting CCNE1 and ERBB2 is validated. In this work, we provide an understanding of genomic characteristics of AFPGC and propose a platform to explore and validate the genome-guided personalized treatment for this disease.

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Seronegative Alpha-Fetoprotein-Producing Early Gastric Cancer Treated with Endoscopic Mucosal Resection and Additional Surgery

Cited by 13 publications

References 8 publications

Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

Coexistence of Choriocarcinoma and Hepatoid Adenocarcinoma in Early Gastric Cancer

Whole-exome sequencing of alpha-fetoprotein producing gastric carcinoma reveals genomic profile and therapeutic targets

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