α‐fetoprotein‐producing rectal cancer: Calculated tumor marker doubling time

Satō, Yoshihiro; Sekine, Takeshi; Ohwada, Susumu

doi:10.1002/jso.2930550414

Cited by 34 publications

(9 citation statements)

References 11 publications

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“…AFP-producing gastric cancers are associated with aggressive clinical behavior and poorer prognosis compared to AFP-negative gastric cancer because of a significantly higher incidence of vascular invasion, lymph node metastasis, and liver metastasis [ 6 , 8 , 9 ]. As for AFP-producing colorectal cancers, a similar tendency has been observed in previous reports and their reviews of up to 12 patients [ 10 – 13 ]. Patients with AFP-producing colorectal cancer underwent several treatments, including surgery and chemotherapy according to conventional colorectal cancer treatment.…”

Section: Case Presentationsupporting

confidence: 84%

Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report

et al. 2018

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BackgroundAlpha-fetoprotein (AFP) is produced by some tumors, such as hepatocellular carcinoma and yolk sac tumors, leading to an increase in serum AFP level. However, AFP in colorectal cancer is extremely rare. Treatment for AFP-producing cancer is often performed according to conventional methods, but oncological outcomes of both surgery and chemotherapy are poor. We report a case of a patient with AFP-producing rectal cancer which successfully responded to preoperative chemoradiotherapy.Case presentationRectal tumor was diagnosed in a 68-year-old man referred to our hospital. Colonoscopy showed a type 2 tumor in the lower rectum, and biopsy revealed an adenocarcinoma with enteroblastic differentiation. Serum tumor marker levels were 8.8 ng/ml in carcinoembryonic antigen (CEA) and 28.3 ng/ml in AFP. Clinical diagnosis was stage IIIB (T3N1M0), and preoperative chemoradiotherapy was performed to prevent local recurrence. Effective tumor reduction was observed, and serum tumor marker levels decreased to normal range. Low anterior resection with temporary diverting ileostomy was performed, and histology revealed residual adenocarcinoma. Pathological diagnosis was stage I (T2N0M0). The tumor was found to be an AFP-producing adenocarcinoma on further immunohistopathological examination. The postoperative course was uneventful, and the patient received adjuvant chemotherapy for 3 months.ConclusionsThe outcomes of preoperative chemoradiotherapy against AFP-producing rectal cancer are reported here for the first time. Based on our experience with this patient, it appears preoperative chemoradiotherapy for patients with AFP-producing advanced rectal cancer is feasible.

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Section: Case Presentationsupporting

confidence: 84%

Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report

et al. 2018

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“…The serum α-fetoprotein (AFP) is the most widely-used HCC biomarker [ 2 ], and many physicians use AFP in clinical practice to diagnose HCC so far [ 3 ]. However, the current Western guidelines [ 4 , 5 ] have excluded AFP measurement for the diagnosis of HCC, because of its limited accuracy in detecting HCC, with a sensitivity of about 60% at a cut-off value of 20 ng/mL [ 4 , 6 ] and low specificity [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance of Alpha-Fetoprotein, Protein Induced by Vitamin K Absence, Osteopontin, Dickkopf-1 and Its Combinations for Hepatocellular Carcinoma

et al. 2016

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Background & AimsAlpha-fetoprotein (AFP) is the most widely used serum biomarker for hepatocellular carcinoma (HCC), despite its limitations. As complementary biomarkers, protein induced by vitamin K absence (PIVKA-II), osteopontin (OPN), and Dickkopf-1 (DKK-1) have been proposed. This study aimed to perform a head-to-head comparison of the diagnostic performance of AFP, PIVKA-II, OPN and DKK-1 as single or in combination to seek the best biomarker or panel, and to investigate the clinical factors affecting their performance.MethodsUsing 401 stored plasma samples obtained from 208 HCC patients and 193 liver cirrhosis control patients, plasma AFP, PIVKA-II, OPN and DKK-1 levels were measured by ELISA, and receiver operating characteristic curve analyses were performed for each biomarker and for every combination of two to four markers.ResultsOf the four biomarkers, AFP showed the highest area under the curve (0.786). The sensitivity and specificity for each single biomarker was 62% and 90.2% (AFP>20 ng/mL), 51.0% and 91.2% (PIVKA-II>10 ng/mL), 46.2% and 80.3% (OPN>100 ng/mL), and 50.0% and 80.8% (DKK-1>500 pg/mL), respectively. Among the combinations of two biomarkers, AFP>20 ng/mL or DKK-1>500 pg/mL showed the best diagnostic performance (sensitivity 78.4%, specificity 72.5%). Triple or quadruple combination did not improve the diagnostic performance further. The patient’s age, etiology and tumor invasiveness of HCC affected the performance of each marker.ConclusionsAFP was the most useful single biomarker for HCC diagnosis, and the combined measurement of AFP and DKK-1 could maximize the diagnostic yield. Clinical decision should be based on the consideration of various factors affecting the diagnostic performance of each biomarker. Efforts to seek novel HCC biomarkers should be continued.

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“…[ 8 ] 54/M R 5,126 Ulcerated Serosal + Liver Well 0M dead 3 Sato et al . [ 9 ] 43/M R 7,060 Ulcerated Extraserosal + Liver Well-mod 4M dead 4 Hocking et al . [ 10 ] 39/F S/C 7,200 NS Perforation + Liver a 1M dead 5 Kato et al .…”

Section: Discussionmentioning

confidence: 99%

Alpha-fetoprotein-producing early rectal carcinoma: a rare case report and review

et al. 2015

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BackgroundAlpha-fetoprotein (AFP)-producing rectal cancer is very rare, and this type of cancer frequently metastasizes to the liver with a poor prognosis. To date, only 11 cases of AFP-producing colorectal cancer have been reported.Case presentationA 41-year-old woman was first presented to the hospital for anal bleeding. An elevated tumor with a central shallow depression in the lower rectum was detected by colonoscopy. Transanal excision was performed, and the histology revealed adenocarcinoma. Further immunohistopathological examination revealed that the tumor was an AFP-producing adenocarcinoma of the rectum. Although local resection was performed 2 months before the diagnosis of AFP tumor, the serum AFP level was normal. The depth of the submucosal invasion was 5,000 μm, and there was venous invasion. Also, no lymphatic invasion was detected. Therefore, additional surgical resection with lymph node dissection was conducted, and the patient underwent laparoscopic intersphincteric resection. No residual cancer was identified in the surgical specimens, and there was no evidence of lymph node metastasis. The patient was discharged 18 days postoperatively, and 12 months after the operation, there are no signs of recurrence.ConclusionTo the best of our knowledge, this is the first case of an AFP-producing rectal cancer that was diagnosed at an early stage.

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α‐fetoprotein‐producing rectal cancer: Calculated tumor marker doubling time

Cited by 34 publications

References 11 publications

Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report

Alpha-fetoprotein-producing rectal cancer successfully responded to preoperative chemoradiotherapy: case report

Diagnostic Performance of Alpha-Fetoprotein, Protein Induced by Vitamin K Absence, Osteopontin, Dickkopf-1 and Its Combinations for Hepatocellular Carcinoma

Alpha-fetoprotein-producing early rectal carcinoma: a rare case report and review

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