胃肝样腺癌血清甲胎蛋白阳性的临床意义

Clinical significance of the electropositive α-fetoprotein in hepatoid adenocarcinoma of stomach

目的探讨胃肝样腺癌（hepatoid adenocarcinoma of stomach,HAS）甲胎蛋白（α-fetoprotein,AFP）阳性的临床意义。方法分析经病理确诊为胃肝样腺癌患者15例的AFP水平,-包括术前测定其血清AFP浓度改变及术后免疫组化测定的肝样腺癌组织AFP的表达,评价AFP水平在诊断胃肝样腺癌时的价值。结果 15例患者术前血清AFP浓度范围为1.51~20 000μg/L;术后癌组织甲胎蛋白表达,AFP染色12例呈阳性,其中,3例呈强阳性（＋＋＋）,4例呈阳性（＋＋）,5例呈弱阳性（＋）。AFP表达3例呈阴性（-）。AFP阳性胃癌分为肝样化和肠化两种类型,前者血清AFP较高（即HAS）,后者AFP滴度较低。结论胃肝样腺癌AFP水平波动范围大,血清AFP升高是HAS重要的临床病理特点,AFP水平在HAS诊治中具有重要价值,可作为早期诊断的条件之一,胃癌患者术前应列为常规检查。

Objective To investigate the expression of AFP in hepatoid adenocarcin of the stomach（HAS）.Methods AFP in 15 cases of HAS verified by the pathology was respectively analyzed.Included the serumlevels of AFP ante-operation and the hepatoid adenocarcinom levels of AFP by immunohistochemisty,the worth of AFP was evaluated in HAS diagnosis.Results In the 15 cases,the serum AFP were 1.51-20 000 μg/L;the hepatoid adenocarcinom AFP were detected by immunohistochemisty,3 cases were hadro-positive,4 cases were positive,and 5 cases were weakly positive,3 cases were negative.AFP-positive-HAS included two phenotypes,one was hepatoid with high serum AFP,and the other was enteroid with relatively lower serum AFP.Conclusion Serum AFP in HAS fluctuate in large range.High Serum AFP is an important parameter and has diagnostic value in HAS.Serum AFP represents an early diagnostic parameter and should be routinely tested.