Novel characteristics of alpha-fetoprotein (AFP)-producing gastric cancer

Although serum AFP level is increased in the AFP-producing gastric cancer (GC) patient, AFP-producing GC may become recurrent without re-elevation of serum AFP level. Therefore, novel characteristics of AFP-producing GC such as other biomarkers are to be explored.

35 AFP-GC and 48 non-AFP-GC patients were included. Our present study revealed that blood type O (15 cases, 42.8%) and A (18 cases, 37.5%) were predominantly observed among AFP-GC and non-AFP-GC patients, respectively. Intriguingly, the least consistently was blood type AB (8.5%, 14.6%). Among AFP-GC patients, pre-operative serum AFP levels were weakly and reversely associated with pre-operative percentage of lymphocytes in the peripheral blood (R2 = 0.1556). The level of alkaline phosphatase (ALP) was highly correlated with the level of lactate dehydrogenase (LDH) (R² = 0.6682) and CEA (R² = 0.6813). The level of CEA was moderately correlated with the level of LDH (R² = 0.3903). By contrast, no any associations between ALP, LDH, CEA, AFP, and peripheral lymphocytes were observed among those 48 non-AFP-GC patients.

Retrospective analysis was carried out for 2773 inpatients of gastric cancer from January 2012 to November 2016 in the Second Affiliated Hospital of Zhejiang University School of Medicine.

The aggressive biological features of AFP-producing GC are closely associated with abnormality of other tumor biomarkers and decrease of the proportion of peripheral lymphocytes, implying that post-operative increase of peripheral lymphocytes might benefit GC patients. Combined use of multiple biomarkers is of significance in comprehensive evaluation of AFP-producing GC patients and assessment for those with high risk of cancer recurrence.