Immunocytochemical presentation of alpha‐fetoprotein‐producing gastric cancer in ascitic fluid: A case study

Kobayashi, Tadao K.; Gotoh, Takechika; Kamachi, M.; Watanabe, Shinsuke; Sawaragi, I

doi:10.1002/dc.2840040207

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…2 As a diagnostic basis, serum AFP levels of most AFPGC were only slightly higher than normal, but in some cases, the serum AFP levels were even beyond the detection limit. [3][4][5] In some AFPGCs, it was observed that certain lesions mimicked HCC-like morphology under a light microscope. The lesions were composed of large, polygonal cells with abundant eosinophilic cytoplasm.…”

Section: Introductionmentioning

confidence: 99%

<p>Effect of Immune Checkpoint Inhibitors Plus Chemotherapy on Advanced Gastric Cancer Patients with Elevated Serum AFP or Hepatoid Adenocarcinoma</p>

et al. 2020

CMAR

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Purpose Alpha-fetoprotein-producing gastric cancer (AFPGC) and hepatoid adenocarcinoma of stomach (HAS) are rare types of gastric cancer, with specific clinical manifestations and poor prognosis. The standardized treatment process of such cancers remains elusive. We aim to investigate the efficacy of immunotherapy combined with chemotherapy on patients with AFPGC or HAS. Patients and Methods AFPGC and HAS patients who underwent immunotherapy and/or chemotherapy as the first-line treatment at our institute from June 2016 to December 2018 were enrolled in this observational study. Their clinicopathological characteristics, serum AFP level and treatment methods were collected. The progression-free survival (PFS) and overall survival (OS) were analyzed and compared between patients who received immunotherapy plus chemotherapy and those received chemotherapy. Results A total of 21 patients with advanced AFPGC or HAS were included in the study and the median follow-up time was 28.0 months. Of the 21 patients, 7 patients received immunotherapy of PD-1 antibody (nivolumab) plus chemotherapy and 14 patients as control received chemotherapy with or without Herceptin/Apatinib. The median progression-free survival (mPFS) time was 5.0 months (4.3 months in the control group and 22.0 months in the immunotherapy group). The median overall survival (mOS) time of the control group was 16.0 months (14.0 months in chemotherapy alone subgroup, 20.0 months in chemotherapy plus Apatinib or Herceptin subgroup), while the mOS of patients receiving immunotherapy was not reached. Conclusion This study suggested PD-1 checkpoint inhibitor plus chemotherapy could benefit AFPGC and HAS patients. Its mechanism of action warrants further investigation.

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Section: Introductionmentioning

confidence: 99%

<p>Effect of Immune Checkpoint Inhibitors Plus Chemotherapy on Advanced Gastric Cancer Patients with Elevated Serum AFP or Hepatoid Adenocarcinoma</p>

et al. 2020

CMAR

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“…As a diagnostic rule, serum AFP levels of most AFPGC were only slightly higher than normal, but in some cases, they were as high as several thousand ng/mL or more, even beyond the detection limit [15][16][17]. Some researchers observed that certain lesions mimicked HCC-like morphology under the light microscope, especially in these AFPGCs with high serum level of AFP.…”

Section: Introductionmentioning

confidence: 99%

Hepatoid Adenocarcinoma of Stomach: Emphasis on the Clinical Relationship with Alpha-Fetoprotein-Positive Gastric Cancer

Chen

Wei

Liu

et al. 2019

BioMed Research International

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Aims. Both hepatoid adenocarcinoma of stomach (HAS) and alpha-fetoprotein-positive gastric cancer (AFPGC) are rare but aggressive subtypes of gastric cancer, but few studies focus on the clinicopathologic differences and prognostic factors between them because of their rarity and histologic overlap. And the significance of AFP level in HAS prognosis was not well studied. Methods. 41 patients with AFPGC and 52 patients with HAS were included in this study. e clinicopathologic features were compared by Chi-square analysis. Prognostic factors for overall survival (OS) and disease-free survival (DFS) were analyzed with the Kaplan-Meier method. Results. e patients with HAS were of a younger age compared with AFPGC, and nearly 60% of tumor located in the gastric antrum and the gastric fundus of cardia. e OS of AFPGC was shorter than that of HAS, due to a higher rate of metastasis. Furthermore, the survival analysis showed that HAS with high AFP expression (AFP High HAS) had a significantly poorer OS compared to HAS with low AFP expression (AFP Low HAS) (P � 0.046). Conclusions. Compared with AFPGC, the patients of HAS were of a younger age and had less rate of liver and other organ metastasis. e serum AFP level was a sensitive prognostic indicator for OS. erefore, much attention should be paid to AFP High HAS in clinical practice.

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“…TRACT [36][37][38][39][40][41][42][43][44][45] Gastrointestinal carcinomas develop malignant effusions in 20-30% of cases. In men they are the most common cause and in women the second most common cause of malignant peritoneal effusions.…”

Section: Carcinomas Of the Gastrointestinalmentioning

confidence: 99%

Metastatic Carcinoma in Effusions

Shidham¹

2022

Cytojournal

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Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through narrow gaps (stoma) in the lining. Carcinomas mainly metastasize to serosa via the lymphatic vessels, which may be blocked leading to effusion. Primary carcinomas of organs such as lung, intestines, liver, ovary, etc., lined by serosal membranes may spread by direct extension, resulting in malignant effusions. As standard of practice, unless specified, cytopathologic examination of serous effusions implies detection of malignant cells. As compared to a surgical biopsy from a small focal area of an extensive serosal surface, effusion fluid from respective cavity exfoliates the cells from the entire serosal surface with minimal chance of sampling artifact. Because of this, effusion fluid cytology generally provides a higher diagnostic yield as compared to biopsy of the serous lining, as demonstrated by some studies. However, various challenges related to effusion fluid cytology makes the interpretation of effusion fluid cytology a field with potential misinterpretations, especially for those without proper experience or training. Developing and following a methodical approach is important for appropriate cytologic examination of effusion fluids. Proper approach may achieve definitive interpretation even without ancillary tests. However, lack of appropriate approach and processing may introduce a significant variation in interpretation due to combination of well-recognized diagnostic pitfalls, which may lead to lower reproducibility and even serious misinterpretations. Current review discusses in brief appropriate approach to processing and evaluating effusion fluid cytology for metastatic carcinoma. At general level, this is comparable to that of other specimens; however, it is critical to modify with reference to the limitations associated with effusion cytology.

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Immunocytochemical presentation of alpha‐fetoprotein‐producing gastric cancer in ascitic fluid: A case study

Cited by 5 publications

References 13 publications

<p>Effect of Immune Checkpoint Inhibitors Plus Chemotherapy on Advanced Gastric Cancer Patients with Elevated Serum AFP or Hepatoid Adenocarcinoma</p>

<p>Effect of Immune Checkpoint Inhibitors Plus Chemotherapy on Advanced Gastric Cancer Patients with Elevated Serum AFP or Hepatoid Adenocarcinoma</p>

Hepatoid Adenocarcinoma of Stomach: Emphasis on the Clinical Relationship with Alpha-Fetoprotein-Positive Gastric Cancer

Metastatic Carcinoma in Effusions

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