Granulocyte-Stimulating Factor Producing Gastric Carcinoma: Case Report and Literature Review

Granulocyte-colony stimulating factor および alpha-fetoprotein 産生胃癌の 1 例小森徹也 1) 村元雅之 1) 長谷川毅 1) 杉戸伸好 1)彎側に 2 型胃癌を認めた．術前の白血球数は 33,150/μl，血清 granulocyte-colony stimulating factor(以下，G-CSF と略記)値は 659 pg/ml，alpha-fetoprotein(以下，AFP と略記)値は 171.2 ng/ml と高値であった．幽門側胃切除術および横行結腸間膜合併切除術を施行した．病理組織学的所見は，pap，pT3，pN2，M0， Stage IIIA であり，抗 G-CSF 抗体および抗 AFP 抗体を用いた免疫組織染色検査は陽性であった．術後 7 日目の白血球数は 6,530/μl，血清 G-CSF 値は 42.7 pg/ml，AFP 値は 37.9 ng/ml と低下を認めた．免疫組織学的検査に G-CSF および AFP 産生胃癌を証明した報告がなく，本症例が初めての報告である．キーワード：granulocyte-colony stimulating factor(G-CSF) ，alpha-fetoprotein(AFP) ，胃癌はじめに悪性腫瘍患者において，明らかな感染症や血液疾患を合併していないにもかかわらず白血球数が異常高値を示すことがあり，その原因の一つとして腫瘍自体が産生する granulocyte-colony stimulating factor(以下，G-CSF と略記)が挙げられる．G-CSF 産生腫瘍は，1974 年に Robinson 1 ) により初めて報告され，本邦においても 1977 年に Asano ら 2 ) が G-CSF 産生肺癌を報告して以来，肺癌患者を中心に多くの報告がなされているが，胃癌患者における報告は比較的まれである．一方，alpha-fetoprotein(以下，AFP と略記)産生胃癌は，1970 年に Bourreille ら 3 ) により初めて報告されて以来，多くの症例が報告されている．本邦において G-CSF 産生胃癌もしくは AFP 産生胃癌の単独での報告はあるが，それらを同時に産生する胃癌症例の報告は 1 例 4 ) のみであり，免疫組織学的検査に証明されていない．今回，我々は術前の血清 G-CSF 値および AFP 値が高値を示し，術後の免疫組織学的検査でそれらの産生を証明した胃癌の 1 例を経験したので文献的考察を加えて報告する．症例患者：76 歳，男性主訴：ふらつき，全身倦怠感既往歴：Basedow 病(28 歳) ，肺結核(50 歳) ，十二指腸潰瘍(60 歳) 現病歴：1 か月前よりふらつきと全身倦怠感を認め，徐々に悪化するため当院を受診した．採血検査に

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Granulocyte-Colony Stimulating Factor and Alpha-Fetoprotein Producing Gastric Cancer

徹也

雅之

毅

et al. 2018

Jpn J Gastroenterol Surg, Nihon Shokaki Geka Gakkai zasshi

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A Case of Primary Squamous Cell Carcinoma of the Stomach

Oe¹,

Yagi²,

Ando³

et al. 2012

Jpn J Gastroenterol Surg

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Granulocyte-Colony Stimulating Factor (G-CSF)-Producing Esophageal Squamous Cell Carcinoma: A Case Report

Shimakawa

Asaka

Usuda

et al. 2014

International Surgery

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There are very few reports of esophageal G-CSF-producing cancer. This report describes a case of G-CSF-producing esophageal squamous cell carcinoma we recently encountered. A 70-year-old male patient had Stage III esophageal squamous cell carcinoma. The patient received preoperative chemotherapy, and therapeutic response for the primary lesion was rated as complete response and that of the lymph node metastasis as stable disease. A radical operation was then performed. A relapse to neutrophilia occurred as liver metastasis recurred postoperation, and serum G-CSF level was high. Immunohistochemical staining of the resected specimen with anti-G-CSF antibody was positive. The patient died about 1 year after the operation. According to our search of the literature, there are 22 cases of esophageal G-CSF-producing cancer. Carcinosarcoma was more frequent as compared to esophageal non-G-CSF-producing cancer. The prognosis was graver in those cases of G-CSF-producing squamous cell carcinoma, relative to cases of non-G-CSF-producing esophageal squamous cell carcinoma.

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Granulocyte-Stimulating Factor Producing Gastric Carcinoma: Case Report and Literature Review

Abstract: r me t a s t a s e s （a r r o ws ）． b ：S OL wa s f o u n d t o h a v e s h r u n k a mo n t h a f t e r s u r g e r y . c ：Th e S OL g r e w u p a g a i n t h r e e mo n t h s a f t e r s u r g e r y .

Cited by 3 publications

References 9 publications

Granulocyte-Colony Stimulating Factor and Alpha-Fetoprotein Producing Gastric Cancer

Granulocyte-Colony Stimulating Factor and Alpha-Fetoprotein Producing Gastric Cancer

A Case of Primary Squamous Cell Carcinoma of the Stomach

Granulocyte-Colony Stimulating Factor (G-CSF)-Producing Esophageal Squamous Cell Carcinoma: A Case Report

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Granulocyte-Stimulating Factor Producing Gastric Carcinoma: Case Report and Literature Review

Abstract: r me t a s t a s e s （a r r o ws ） ． b ：S OL wa s f o u n d t o h a v e s h r u n k a mo n t h a f t e r s u r g e r y . c ：Th e S OL g r e w u p a g a i n t h r e e mo n t h s a f t e r s u r g e r y .

Cited by 3 publications

References 9 publications

Granulocyte-Colony Stimulating Factor and Alpha-Fetoprotein Producing Gastric Cancer

Granulocyte-Colony Stimulating Factor and Alpha-Fetoprotein Producing Gastric Cancer

A Case of Primary Squamous Cell Carcinoma of the Stomach

Granulocyte-Colony Stimulating Factor (G-CSF)-Producing Esophageal Squamous Cell Carcinoma: A Case Report

Contact Info

Product

Resources

About

Abstract: r me t a s t a s e s （a r r o ws ）． b ：S OL wa s f o u n d t o h a v e s h r u n k a mo n t h a f t e r s u r g e r y . c ：Th e S OL g r e w u p a g a i n t h r e e mo n t h s a f t e r s u r g e r y .