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Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Cancer Biomarker | Research

Prognostic significance of preoperative serum tumor markers in hepatoid adenocarcinoma of stomach (HAS)

Authors: Xuesong Yang, Anqiang Wang, Jialin Li, Kai Zhou, Ke Ji, Xin Ji, Ji Zhang, Xiaojiang Wu, Zhaode Bu

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

The role of preoperative serum tumor markers in HAS patients was vague, we designed the study to explore the effect of preoperative serum tumor markers on predicting the prognosis of HAS patients.

Methods

A total of 139 patients were included according to the different tumor makers. X-tile tool was employed to identify the optimal cut-off values of respective tumor makers. Multivariate analyses were conducted to determine independent risk factors.

Results

The optimal cut-off value of alpha-fetoprotein (AFP) for 3-years overall survival (OS) and recurrence-free survival (RFS) was 516 ng/mL. Patients with high-level AFP values assumed significantly worse OS and RFS than those with low-level AFP values (P = 0.028 and P = 0.011, respectively). The optimal cut-off value of Carbohydrate antigen (CA)19–9 for OS and RFS was 51.3 U/mL. And the survival results were similar with AFP in the aspects of OS and RFS (P = 0.009 and P < 0.001, respectively). Multivariate analyses showed that high serum AFP was an independent risk factor for OS and RFS of HAS patients (HR7.264; 95% CI 1.328–39.738; P = 0.022 and HR 2.688; 95% CI 0.922–7.836; P = 0.070, respectively). CA19–9 could perform as a fair substitute to predict the HAS patients’ OS and RFS when the preoperative serum AFP was unavailable (HR 7.816; 95% CI 2.084–29.308; P = 0.002 and HR 4.386; 95% CI 1.824–10.547; P = 0.001, respectively). Other tumor markers didn’t present significant influences.

Conclusions

Applying preoperative serum AFP level to predict the HAS patients’ prognosis is feasible and preoperative serum high-AFP is an independent risk factor for OS and RFS of HAS patients. Preoperative serum CA19–9 could be an alternative choice when AFP was absent.
Literature
1.
go back to reference Sun D, Cao M, Li H, He S, Chen W. Cancer burden and trends in China: a review and comparison with Japan and South Korea. Chin J Cancer Res. 2020;32(2):129–39.CrossRef Sun D, Cao M, Li H, He S, Chen W. Cancer burden and trends in China: a review and comparison with Japan and South Korea. Chin J Cancer Res. 2020;32(2):129–39.CrossRef
2.
go back to reference Zeng XY, Yin YP, Xiao H, Zhang P, He J, Liu WZ, et al. Clinicopathological characteristics and prognosis of Hepatoid adenocarcinoma of the stomach: evaluation of a pooled case series. Curr Med Sci. 2018;38(6):1054–61.CrossRef Zeng XY, Yin YP, Xiao H, Zhang P, He J, Liu WZ, et al. Clinicopathological characteristics and prognosis of Hepatoid adenocarcinoma of the stomach: evaluation of a pooled case series. Curr Med Sci. 2018;38(6):1054–61.CrossRef
3.
go back to reference Fakhruddin N, Bahmad HF, Aridi T, Yammine Y, Mahfouz R, Boulos F, et al. Hepatoid adenocarcinoma of the stomach: a challenging diagnostic and therapeutic disease through a case report and review of the literature. Front Med-Lausanne. 2017;4:164.CrossRef Fakhruddin N, Bahmad HF, Aridi T, Yammine Y, Mahfouz R, Boulos F, et al. Hepatoid adenocarcinoma of the stomach: a challenging diagnostic and therapeutic disease through a case report and review of the literature. Front Med-Lausanne. 2017;4:164.CrossRef
4.
go back to reference Tsuruta S, Ohishi Y, Fujiwara M, Ihara E, Ogawa Y, Oki E, et al. Gastric hepatoid adenocarcinomas are a genetically heterogenous group; most tumors show chromosomal instability, but MSI tumors do exist. Hum Pathol. 2019;88:27–38.CrossRef Tsuruta S, Ohishi Y, Fujiwara M, Ihara E, Ogawa Y, Oki E, et al. Gastric hepatoid adenocarcinomas are a genetically heterogenous group; most tumors show chromosomal instability, but MSI tumors do exist. Hum Pathol. 2019;88:27–38.CrossRef
5.
go back to reference Wang Y, Sun L, Li Z, Gao J, Ge S, Zhang C, et al. Hepatoid adenocarcinoma of the stomach: a unique subgroup with distinct clinicopathological and molecular features. Gastric Cancer. 2019;22(6):1183–92.CrossRef Wang Y, Sun L, Li Z, Gao J, Ge S, Zhang C, et al. Hepatoid adenocarcinoma of the stomach: a unique subgroup with distinct clinicopathological and molecular features. Gastric Cancer. 2019;22(6):1183–92.CrossRef
6.
go back to reference Yang J, Wang R, Zhang W, Zhuang W, Wang M, Tang C. Clinicopathological and prognostic characteristics of hepatoid adenocarcinoma of the stomach. Gastroenterol Res Pract. 2014;2014:140587.CrossRef Yang J, Wang R, Zhang W, Zhuang W, Wang M, Tang C. Clinicopathological and prognostic characteristics of hepatoid adenocarcinoma of the stomach. Gastroenterol Res Pract. 2014;2014:140587.CrossRef
7.
go back to reference Zhao M, Sun L, Lai JZ, Shi H, Mei K, He X, et al. Expression of RNA-binding protein LIN28 in classic gastric hepatoid carcinomas, gastric fetal type gastrointestinal adenocarcinomas, and hepatocellular carcinomas: an immunohistochemical study with comparison to SALL4, alpha-fetoprotein, glypican-3, and Hep Par1. Pathol Res Pract. 2018;214(10):1707–12.CrossRef Zhao M, Sun L, Lai JZ, Shi H, Mei K, He X, et al. Expression of RNA-binding protein LIN28 in classic gastric hepatoid carcinomas, gastric fetal type gastrointestinal adenocarcinomas, and hepatocellular carcinomas: an immunohistochemical study with comparison to SALL4, alpha-fetoprotein, glypican-3, and Hep Par1. Pathol Res Pract. 2018;214(10):1707–12.CrossRef
8.
go back to reference Marrelli D, Pinto E, De Stefano A, De Manzoni G, Farnetani M, Garosi L, et al. Preoperative positivity of serum tumor markers is a strong predictor of hematogenous recurrence of gastric cancer. J Surg Oncol. 2001;78(4):253–8.CrossRef Marrelli D, Pinto E, De Stefano A, De Manzoni G, Farnetani M, Garosi L, et al. Preoperative positivity of serum tumor markers is a strong predictor of hematogenous recurrence of gastric cancer. J Surg Oncol. 2001;78(4):253–8.CrossRef
9.
go back to reference Chen Y, Qu H, Jian M, Sun G, He Q. High level of serum AFP is an independent negative prognostic factor in gastric cancer. Int J Biol Markers. 2015;30(4):e387–93.CrossRef Chen Y, Qu H, Jian M, Sun G, He Q. High level of serum AFP is an independent negative prognostic factor in gastric cancer. Int J Biol Markers. 2015;30(4):e387–93.CrossRef
10.
go back to reference Wang XZ, Zeng ZY, Ye X, Sun J, Zhang ZM, Kang WM. Interpretation of the development of neoadjuvant therapy for gastric cancer based on the vicissitudes of the NCCN guidelines. World J Gastrointest Oncol. 2020;12(1):37–53.CrossRef Wang XZ, Zeng ZY, Ye X, Sun J, Zhang ZM, Kang WM. Interpretation of the development of neoadjuvant therapy for gastric cancer based on the vicissitudes of the NCCN guidelines. World J Gastrointest Oncol. 2020;12(1):37–53.CrossRef
11.
go back to reference National Health Commission of the People's republic of C. Chinese guidelines for diagnosis and treatment of gastric cancer 2018 (English version). Chin J Cancer Res. 2019;31(5):707–37.CrossRef National Health Commission of the People's republic of C. Chinese guidelines for diagnosis and treatment of gastric cancer 2018 (English version). Chin J Cancer Res. 2019;31(5):707–37.CrossRef
12.
go back to reference Ishikura H, Kirimoto K, Shamoto M, Miyamoto Y, Yamagiwa H, Itoh T, et al. Hepatoid adenocarcinomas of the stomach. An analysis of seven cases. Cancer. 1986;58(1):119–26.CrossRef Ishikura H, Kirimoto K, Shamoto M, Miyamoto Y, Yamagiwa H, Itoh T, et al. Hepatoid adenocarcinomas of the stomach. An analysis of seven cases. Cancer. 1986;58(1):119–26.CrossRef
13.
go back to reference Nagai E, Ueyama T, Yao T, Tsuneyoshi M. Hepatoid adenocarcinoma of the stomach. a clinicopathologic and immunohistochemical analysis. Cancer. 1993;72(6):1827–35.CrossRef Nagai E, Ueyama T, Yao T, Tsuneyoshi M. Hepatoid adenocarcinoma of the stomach. a clinicopathologic and immunohistochemical analysis. Cancer. 1993;72(6):1827–35.CrossRef
14.
go back to reference Wang FH, Zhang XT, Li YF, Tang L, Qu XJ, Ying JE, et al. The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021. Cancer Commun (Lond). 2021;41(8):747–95.CrossRef Wang FH, Zhang XT, Li YF, Tang L, Qu XJ, Ying JE, et al. The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021. Cancer Commun (Lond). 2021;41(8):747–95.CrossRef
15.
go back to reference Camp RL, Dolled-Filhart M, Rimm DL. X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res. 2004;10(21):7252–9.CrossRef Camp RL, Dolled-Filhart M, Rimm DL. X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res. 2004;10(21):7252–9.CrossRef
16.
go back to reference Qu BG, Bi WM, Qu BT, Qu T, Han XH, Wang H, et al. PRISMA-compliant article: clinical characteristics and factors influencing prognosis of patients with Hepatoid adenocarcinoma of the stomach in China. Medicine (Baltimore). 2016;95(15):e3399.CrossRef Qu BG, Bi WM, Qu BT, Qu T, Han XH, Wang H, et al. PRISMA-compliant article: clinical characteristics and factors influencing prognosis of patients with Hepatoid adenocarcinoma of the stomach in China. Medicine (Baltimore). 2016;95(15):e3399.CrossRef
17.
go back to reference Su JS, Chen YT, Wang RC, Wu CY, Lee SW, Lee TY. Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroentero. 2013;19(3):321–7.CrossRef Su JS, Chen YT, Wang RC, Wu CY, Lee SW, Lee TY. Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroentero. 2013;19(3):321–7.CrossRef
18.
go back to reference Zhu MY, Li W, Lu Y, Dong X, Lin B, Chen Y, et al. HBx drives alpha fetoprotein expression to promote initiation of liver cancer stem cells through activating PI3K/AKT signal pathway. Int J Cancer. 2017;140(6):1346–55.CrossRef Zhu MY, Li W, Lu Y, Dong X, Lin B, Chen Y, et al. HBx drives alpha fetoprotein expression to promote initiation of liver cancer stem cells through activating PI3K/AKT signal pathway. Int J Cancer. 2017;140(6):1346–55.CrossRef
19.
go back to reference Liu X, Cheng Y, Sheng W, Lu H, Xu X, Xu Y, et al. Analysis of clinicopathologic features and prognostic factors in hepatoid adenocarcinoma of the stomach. Am J Surg Pathol. 2010;34(10):1465–71.CrossRef Liu X, Cheng Y, Sheng W, Lu H, Xu X, Xu Y, et al. Analysis of clinicopathologic features and prognostic factors in hepatoid adenocarcinoma of the stomach. Am J Surg Pathol. 2010;34(10):1465–71.CrossRef
20.
go back to reference Baek SK, Han SW, Oh DY, Im SA, Kim TY, Bang YJ. Clinicopathologic characteristics and treatment outcomes of hepatoid adenocarcinoma of the stomach, a rare but unique subtype of gastric cancer. BMC Gastroenterol. 2011;11:56.CrossRef Baek SK, Han SW, Oh DY, Im SA, Kim TY, Bang YJ. Clinicopathologic characteristics and treatment outcomes of hepatoid adenocarcinoma of the stomach, a rare but unique subtype of gastric cancer. BMC Gastroenterol. 2011;11:56.CrossRef
21.
go back to reference Lin HJ, Hsieh YH, Fang WL, Huang KH, Li AF. Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer. Curr Oncol. 2014;21(3):e394–9.CrossRef Lin HJ, Hsieh YH, Fang WL, Huang KH, Li AF. Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer. Curr Oncol. 2014;21(3):e394–9.CrossRef
Metadata
Title
Prognostic significance of preoperative serum tumor markers in hepatoid adenocarcinoma of stomach (HAS)
Authors
Xuesong Yang
Anqiang Wang
Jialin Li
Kai Zhou
Ke Ji
Xin Ji
Ji Zhang
Xiaojiang Wu
Zhaode Bu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10516-y

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