Prognostic significance of α-fetoprotein in gastric adenocarcinoma

Introduction
α-fetoprotein (AFP)-producing gastric carcinoma is a rare type of gastric cancer. Compared with other types, it is more aggressive and prone to liver metastases.

Aim
To investigate the prognostic characteristics of AFP in patients with gastric adenocarcinoma.

Material and methods
Our study included 391 patients diagnosed with gastric adenocarcinoma, who were admitted between 2006 and 2019. For all patients, demographic characteristics, location of the lesion, levels of AFP, CEA, and CA19-9, pathology diagnosis, results of operation, and survival status were recorded.

Results
In our study, 68.3% of the patients were male, and the mean age was 62.76 years. In 66 (16.9%) patients, AFP level (cut-off = 8.2 ng/dl) was higher than normal. A total of 26 cases were with AFP > 100 ng/ml. 92.3% of cases with positive AFP gastric cancer were stage 4, and liver metastasis was detected in 80.8%. No significant difference was found between groups with AFP levels of < 100 ng/ml and ≥ 100 ng/ml in terms of gender, location of the lesion, or stage of the tumour. An AFP value higher than 100 ng/ml was significantly associated with liver metastasis, pathological diagnoses, and metastasis status. There was a significant difference in mortality between AFP > 100 ng/ml and age.

Conclusions
Predictors with high predictive value are needed for early diagnosis and screening of gastric cancer. We thought that comprehensive studies on this subject would contribute to the literature and reduce the mortality and economic losses by determining the prognosis of gastric cancer.