Analysis of Clinicopathologic Features and Prognostic Factors in Hepatoid Adenocarcinoma of the Stomach

Liu, Xiaowen; Cheng, Ya-Min; Sheng, Weiqi; Lu, Haizhou; Xu, Xiaohua; Xu, Yu; Long, Ziwen; Zhu, Huiyan; Wang, Yanong

doi:10.1097/pas.0b013e3181f0a873

Cited by 95 publications

(71 citation statements)

References 16 publications

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“…[12,13] Our study revealed a similar incidence rate (0.22%) with a high incidence of metastasis. According to a previously published report, [14] patients with GHA have an average age of 63.5 years, are predominantly male (2.32:1), have tumors mainly located at the antrum, and tend to have high levels of AFP.…”

Section: Discussionsupporting

confidence: 54%

Clinicopathologial features of gastric hepatoid adenocarcinoma

Lin¹,

Yeh²,

Hsu³

et al. 2015

Biomed J

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Section: Discussionsupporting

confidence: 54%

Clinicopathologial features of gastric hepatoid adenocarcinoma

Lin¹,

Yeh²,

Hsu³

et al. 2015

Biomed J

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“…Previous studies have reported that HAS frequently occurred with liver metastasis and exhibited a shorter interval between gastrectomy and liver metastasis than that of CGC, leading to a poorer prognosis (17,18). As reported by Liu et al, the one-, three-and five-year survival rates of HAS were 30, 13 and 9%, respectively, compared with 95, 57 and 38%, respectively in the CGC group (19).…”

Section: A B C Dsupporting

confidence: 56%

Hepatoid adenocarcinoma of the stomach: A case report and review of the literature

et al. 2015

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Abstract. Hepatoid adenocarcinoma is a rare tumor, associated with an extremely poor prognosis. In the present report, a 72-year-old female presented to Huashan Hospital (Shanghai, China) with upper abdominal discomfort and, following endoscopy, an ulcerated lesion was observed in the stomach. A computed tomography scan revealed a mass in the antrum of the stomach and the α-fetoprotein level was normal. Sections of the mass exhibited malignant cells arranged in a solid to trabecular pattern; the cells were polygonal shaped with well-defined cytoplasmic borders. Immunohistochemical analysis was performed and the cells were positive for Hep1, CK, CK8, CK18 and P53. The histological features together with the immunohistochemical findings were diagnostic of a hepatoid adenocarcinoma of the stomach. Immunohistochemical studies may aid in the identification of the characteristic features and prevent the misdiagnosis of this tumor. IntroductionHepatoid adenocarcinoma of the stomach (HAS) is a particular type of extrahepatic adenocarcinoma, presenting with morphological characteristics identical to those of hepatocellular carcinoma (HCC). A case of α-fetoprotein-producing gastric adenocarcinoma was reported by Ishikura et al (1) in 1985. The authors suggested the name of HAS due to the ability of the tumor cells to produce α-fetoprotein (AFP), which is characteristic of hepatoid adenocarcinoma cells (1). HAS is reported to occur with more frequent lymph node and liver metastasis and exhibits a poorer prognosis than common gastric cancer (CGC) (2). HAS is rare (with a worldwide incidence of 0.3-1%) of all kinds of gastric cancer (2-4), the sypmtoms are similar to those of normal gastric cancer (abdominal discomfort, fullness of anorexia, epigastric pain, voimiting and weight loss), surgery is the usual treatment option (4-7). The literature review presented in this study was conducted to contribute towards the improvement of the diagnosis and treatment of HAS (3). We report a case of a 72-year-old female patient who sufferd upper abdominal discomfort. Endoscopical and radiological examination revealed a neoplasm in the stomach, however serum α-fetoprotein levels were normal. Written informed consent was obtained from the patient's family. Case reportCase presentation. A 72-year-old Chinese female presented to Huashan Hospital (Shanghai, China) complaining of upper abdominal discomfort for the previous two months. The patient was admitted to the General Surgery Department of Huashan Hospital on October 8th, 2011. The results of the physical examinations were unremarkable. The past medical history revealed nothing significant; the patient had not previously undergone any surgery and there was no family history of cancer. The laboratory investigation revealed normal blood levels following routine tests, and liver and kidney function were normal. The white blood cell count was 6.8x10 9 /l (normal range, 4.5-11x10 9 /l), the hematocrit level was 120 g/l (normal range, 110-150 g/l), the red blood cell count was 3.93x10 12 /l (...

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“…The lower one third of the stomach is most common location for afpgc or has, in the range 40%-61.5% 3,6,[11][12][13]16 . Our observation was similar.…”

Section: Discussionmentioning

confidence: 99%

“…Liver metastasis (14.3%-75.6%) is one of the main features of afpgc or hepatoid adenocarcinoma of the stomach (has) [12][13][14]16 . In our series, 16 patients (27.6%) in the afpgc group were found to have liver metastasis during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

et al. 2014

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Backgroud: Patients with alpha-fetoprotein (afp)–producing gastric cancer have a high incidence of liver metastasis and poor prognosis. There is some controversy about clinical manifestations in these patients. Methods: Our study enrolled patients who, before surgery, had gastric cancer with serum afp exceeding 20 ng/mL [afp>20 (n = 58)] and with serum afp 20 ng/mL or less [afp≤20 (n = 1236)]. Clinical manifestations were compared between the groups. Results: Early gastric cancer was more frequent (30.1% vs. 4%) and advanced gastric cancer was less frequent (69.9% vs. 96%) in the afp≤20 group than the afp>20 group (p < 0.001). Liver and lymph node metastasis occurred less frequently in the afp≤20 group (4.4% vs. 27.6%, p < 0.001, and 60.7% vs. 91.4%, p < 0.001, respectively). The 1-, 3-, 5-, and 10-year survival rates of afp≤20 patients were 75.2%, 53.4%, 45.8%, and 34.6% respectively. The 1-, 3-, 5-, and 10-year survival rates of patients with afp greater than 20 ng/mL, but 300 ng/mL or less, were 46.7%, 28.9%, 17.8%, and 13.3% respectively. The 1-, 3-, and 5-year survival rates of patients with serum afp greater than 300 ng/mL were 15.4%, 7.7%, and 0% respectively. The independent predictors for survival time were afp concentration, age, peritoneal seeding, liver metastasis, lymph node metastasis, vascular invasion, TNM stage, curative surgery, serosal invasion, and Lauren classification. Conclusions: Patients with high serum afp had a high frequency of liver and lymph node metastasis and very poor prognosis. More aggressive management with multimodal therapy (for example, chemotherapy, radiotherapy) might be needed when treating such patients.

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Analysis of Clinicopathologic Features and Prognostic Factors in Hepatoid Adenocarcinoma of the Stomach

Abstract: HAS had different clinicopathologic features and prognosis from non-HAS.

Cited by 95 publications

References 16 publications

Clinicopathologial features of gastric hepatoid adenocarcinoma

Clinicopathologial features of gastric hepatoid adenocarcinoma

Hepatoid adenocarcinoma of the stomach: A case report and review of the literature

Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

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