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Alpha-fetoprotein for Gastric Cancer Staging: An Essential or Redundant Tumor Marker?
Chun-Yi Tsai1, Keng-Hao Liu1, Cheng-Tang Chiu2
1Department of General Surgery, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan, R.O.C.
Background/Aim:
This study was designed to clarify the value of routine alpha-fetoprotein (AFP) testing for patients with gastric cancer (GC).
Patients And Methods:
A total of 905 patients with newly diagnosed GC and available pretreatment carcinoembryonic antigen (CEA), cancer-related antigen 19-9 (CA19-9), and AFP data from 2010 to 2016 were collected for comparison of tumor stage and survival.
Results:
In total, 139 patients (15.4%), 155 patients (17.1%), and 27 patients (3.0%) had elevated CEA, CA19-9, and AFP levels, respectively. The c-index values of elevated AFP levels in predicting stage IV disease and the 1-year mortality rate were 0.564 (95%CI=0.520-0.608) and 0.594 (95%CI=0.553-0.635), respectively, which were significantly lower than those of CEA (0.673 and 0.665) and CA19-9 (0.619 and 0.618).
Conclusion:
Elevated AFP is rare in patients with newly diagnosed GC. Routine AFP sampling would not provide a higher survival prediction in GC patients than CEA or CA19-9.
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