Clinicopathologial features of gastric hepatoid adenocarcinoma

Lin, Cheng‐Yu; Yeh, Huei-Chung; Hsu, Chen-Ming; Lin, Wey‐Ran; Chiu, Cheng‐Tang

doi:10.4103/2319-4170.126860

Cited by 39 publications

(29 citation statements)

References 26 publications

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“…18 Most HAS cases present as Borrmann's type III fungating lesions with purple, berry-like surfaces. 16 In the present study, the constituent HAS/GC ratio was 0.82%. In addition, the male/female ratio was 3.62:1, and the median age at diagnosis was 61.0 years.…”

Section: Discussionsupporting

confidence: 44%

“…A previous study reported that 10 (0.22%) out of 4563 patients with primary GC were ultimately diagnosed with HAS. 16 The median age at diagnosis of the patients in this previous study was 65.5 years. 2 This type of carcinoma often occurs among the elderly, and it most commonly develops in the antrum.…”

Section: Discussionmentioning

confidence: 76%

“… 22 Giant cells and mitotic figures are frequently found in the hepatoid areas. 17 Tumor cells in both the hepatoid areas 16 , 20 , 23 and glandular areas 20 might exhibit positive immunoreactivity for AFP. The detection of hepatoid differentiation in tumor cells might also be associated with immunohistochemical positivity for alpha-1 antitrypsin, 21 alpha-1 antichymotrypsin, 21 SALL4, 23 HepPar-1, 23 and glypican 3.…”

Section: Discussionmentioning

confidence: 99%

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PRISMA-Compliant Article

et al. 2016

Medicine

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Most previous studies have been single case reports, and studies with large samples are presently lacking. In addition, no studies have investigated the associations between the clinical characteristics and prognosis of hepatoid adenocarcinoma of the stomach (HAS).The aim of this study was to explore the associations of different clinical characteristics with the ages, serum alpha-fetoprotein (AFP) levels, and survival times of HAS patients.The present study was conducted using the CBM disc, HowNet, Wanfang and VIP data resource systems, and PubMed. According to the PRISMA Flow Diagram, certain case reports from the same center, those that did not provide patient age or sex, and those that did not report serum AFP levels or AFP immunohistochemistry results were excluded. A total of 131 relevant articles, including 124 case reports, 5 reviews, and 2 postgraduate Master's theses, were reported in the above-mentioned five databases. We applied inclusion criteria to case reports on the clinical characteristics and prognosis of HAS, which resulted in the ultimate inclusion of 180 patients from 62 case reports for statistical analyses.The main finding was that the age of the men was significantly higher than that of the women (P = 0.004). In addition, the serum AFP levels of the participants with antral disease were significantly higher than those with nonantral disease (P = 0.001). The median serum AFP levels and survival times significantly differed among the patients with the three lesion types (P = 0.001 and 0.019, respectively). The serum AFP levels of the participants with ulcerative-upheaval-type tumors and purely ulcerative tumors were significantly higher than those with upheaval-type tumors (P = 0.000 and 0.017, respectively). In addition, the serum AFP levels of the participants with ulcerative-upheaval-type tumors were significantly higher than those with ulcerative-type tumors (P = 0.019), and their survival time was also significantly higher (P = 0.000). The serum AFP levels of the participants without metastasis or liver metastasis were significantly lower than those with metastasis or liver metastasis (P = 0.000 and 0.000, respectively), and their survival time was significantly longer (P = 0.000 and 0.001, respectively). Finally, the survival time of the participants treated with surgery was significantly longer than those treated using nonsurgical methods (P = 0.046). However, survival analysis revealed that the survival time was only significantly associated with the presence of metastasis (P = 0.002) and liver metastasis (P = 0.036).The main limitations of this study are as follows: it was a retrospective analysis of published case reports, the clinical data were incomplete, and the cases included in subgroup analyses were different.Our study results have demonstrated that the prognosis of HAS patients is poor. In addition, the survival time is significantly negatively correlated with the presence of metastasis and liver metastasis.

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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PRISMA-Compliant Article

et al. 2016

Medicine

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“…reviewed the literature on hepatoid adenocarcinoma between 2001 and 2011 and recently presented a summary on 217 patients, including 182 (83.9%) patients with hepatoid adenocarcinoma located in the stomach. [ 4 ] To add data obtained in more recent years, we have collected pertinent information from recent publications that included a minimum of 10 patients,[ 14 , 19 , 20 , 23 , 25 ] and relevant information is presented in Table 1 . In their review of 26 patients, Baek et al.…”

Section: Resultsmentioning

confidence: 99%

Hepatoid adenocarcinoma of the stomach – proper identification and treatment remain a challenge

Søreide

Greve

Gudlaugsson

et al. 2016

Scandinavian Journal of Gastroenterology

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Objective The term hepatoid adenocarcinoma (HAC) of the stomach was introduced three decades ago with the observation of high serum α-fetoprotein (AFP) levels in some gastric adenocarcinoma patients. This very rare gastric cancer patient subgroup is likely frequently misdiagnosed. Material Two patients who were recently diagnosed with HAC of the stomach at our institution are presented. We also performed a structured literature search and reviewed pertinent articles to provide knowledge to improve the proper identification, diagnosis and management of patients with gastric HAC. Results HAC is a rare subgroup of gastric carcinoma with poor prognosis. Clinical management of this population may be challenging. The scientific literature is largely based on very small patient series or case reports, and the evidence for proper decision making and management is considered weak. Conclusion All physicians involved in the diagnosis and treatment of patients with gastric cancer should pay attention to this rare subgroup to improve identification.

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“…Histologically, typical AFPGC has a liver-like structure and has been frequently reported as hepatoid adenocarcinoma[ 17 - 20 ]. However, there are also histologic types of carcinoma other than hepatoid adenocarcinoma.…”

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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Clinicopathologial features of gastric hepatoid adenocarcinoma

Cited by 39 publications

References 26 publications

PRISMA-Compliant Article

PRISMA-Compliant Article

Hepatoid adenocarcinoma of the stomach – proper identification and treatment remain a challenge

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

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