Novel characteristics of alpha-fetoprotein (AFP)-producing gastric cancer

Abstract

Background: Although serum AFP level is increased in the AFP-producing gastric cancer (GC) patient, AFP-producing GC may become recurrent without re-elevation of serum AFP level. Therefore, novel characteristics of AFP-producing GC such as other biomarkers are to be explored.

Results: 35 AFP-GC and 48 non-AFP-GC patients were included. Our present study revealed that blood type O (15 cases, 42.8%) and A (18 cases, 37.5%) were predominantly observed among AFP-GC and non-AFP-GC patients, respectively. Intriguingly, the least consistently was blood type AB (8.5%, 14.6%). Among AFP-GC patients, pre-operative serum AFP levels were weakly and reversely associated with pre-operative percentage of lymphocytes in the peripheral blood (R2 = 0.1556). The level of alkaline phosphatase (ALP) was highly correlated with the level of lactate dehydrogenase (LDH) (R² = 0.6682) and CEA (R² = 0.6813). The level of CEA was moderately correlated with the level of LDH (R² = 0.3903). By contrast, no any associations between ALP, LDH, CEA, AFP, and peripheral lymphocytes were observed among those 48 non-AFP-GC patients.

Materials and Methods: Retrospective analysis was carried out for 2773 inpatients of gastric cancer from January 2012 to November 2016 in the Second Affiliated Hospital of Zhejiang University School of Medicine.

Conclusions: The aggressive biological features of AFP-producing GC are closely associated with abnormality of other tumor biomarkers and decrease of the proportion of peripheral lymphocytes, implying that post-operative increase of peripheral lymphocytes might benefit GC patients. Combined use of multiple biomarkers is of significance in comprehensive evaluation of AFP-producing GC patients and assessment for those with high risk of cancer recurrence.