ArticleInternational journal of general medicine2026
Morphologic and Immunophenotypic Spectrum of 11 Gastric Cancers with Elevated Serum Alpha-Fetoprotein: Emphasis on Hepatoid or Enteroblastic Differentiation.
Article in International journal of general medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: A retrospective analysis of 11 gastric cancer patients with elevated serum alpha-fetoprotein levels was conducted to investigate the clinical-pathological characteristics, diagnostic approaches, and surgical experiences associated with this disease, thereby enhancing understanding of its biological behavior. Methods: A retrospective analysis of clinical data from gastric cancer patients diagnosed at our hospital between 2020 and 2025 presented with elevated serum alpha-fetoprotein levels, combined with a discussion of disease classification based on relevant literature.The exclusion criteria were:such as hepatocellular carcinoma, cirrhosis/active liver disease, and germ cell tumors. Results: Among the 11 patients, 9 were male, accounting for approximately 81.8%, and 2 were female, accounting for approximately 18.2%. The median age was 68 years.Clinical manifestations included upper abdominal pain, melena, and elevated serum alpha-fetoprotein levels. Eleven patients underwent radical gastrectomy for gastric cancer, including four cases of total gastrectomy. Tumors were located in the cardia in seven patients (63.6%), in the gastric body in three patients (27.3%), and in the gastric antrum in one patient (9.1%).Based on histological type, the cases can be classified as follows: 6 cases of hepatocellular adenocarcinoma and 5 cases of gastric adenocarcinoma with intestinal differentiation.Immunohistochemical staining revealed varying degrees of expression for alpha-fetoprotein, Glypican-3, and SALL-4. Five cases showed positivity for all three markers, eight cases showed positivity for two markers, and eleven cases showed positivity for only one marker. Conclusion: This type of gastric adenocarcinoma is rare, often detected at an advanced stage with a poor prognosis. In clinical diagnosis, it must be distinguished from conventional gastric adenocarcinoma.
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