Author  
Place of duty  
Title   α - fetoprotein 의 상승을 동반한 위선암종의 임상병리학적 고찰 ( Clinico - pathologic Characteristics of Gastric Adenocarcinoma with Increased Serum Alpha - fetoprotein )
Publicationinfo   1992 Jan; 024(05): 674-684.
Key_word  
Full-Text  
Abstract   Gastric adenocarcinoma cells are known to produce fetal proteins into circulation and this fetal proteins detected in the blood have been a useful tool for diagnosis and follow-up of cancer patient. Since the alpha-fetoprotein(AFP) producing gastric adenocarcinoma was identified by immunohistochemistry, its differentiation into hepatoid morphology and its unique clinical course draw clinical attention. Among 300 gastric adenocarcinoma patients whose serum CEA and AFP were available for analysis, we have identified 14 cases of adenocarcinoma with in- creased serum AFP(4.7%). Immunohistochemistry and detailed morphologic analysis were possible in 7 resectable cases. The other 7 cases were unresectable but clinical judgement based on patients history and laboratory data made diagnosis possible. AFP, alpha-1 antitrypsin and CEA were positively stained in most cases in solid area and PAS was positive in all cases. In one case hCG was strongly stained and it showed no hepatoid differentiation. It suggests that AFP producing gastric adenacarcinomas are not always derived from hepatoid differentiation of the forgut. The positivity of AFP was not correlated to the serum levei, however serum AFP level was inva#riably decreased following curative resection of the stomach and bounced back up with recurrence#. Liver was the most frequent site of metastasis in this type of carcino- ma. 4 among 7 resectable cases and all 7 unresectable cases(11/14, 78.6%) show liver involvement at the time of diagnosis or some time after curative resection. In conclusion, gastric adenocarcinoma with increased serum AFP may be different from usual gastric adenocarcinomas in its clinical course as well as its pathogenesis. And its poor proanosis may be attributed to predilection for liver metastasis, which should be watched carefully during follow-up.
저 자   정태준(Te June Chung),성건형(Kun Hyung Sung),장정순(Joung Soon Jang),이종철(Jung Dal Lee),홍은경(Eun Kyung Hong),이중달(Jung Dal Lee)