OBJECTIVETo investigate the clinical features and prognosis factors of α-fetoprotein (AFP) positive gastric cancer patients.

METHODSClinical data of 512 gastric cancer patients undergoing surgery from January 2003 to December 2008 in the General Surgery Department, the First Affiliated Hospital, Dalian Medical University were collected. According to serum AFP level, patients were divided into AFP positive group and AFP negative group. Clinical data and survival time were compared between the two groups. Effect of positive AFP on prognosis was evaluate.

RESULTSThere were 50 AFP positive patients and the ratio was 9.8%. As compared to AFP negative group, AFP positive group had a higher incidence of vascular tumor invasion [12.0%(6/50) vs. 3.7%(17/462), χ(2)=7.28, P<0.05] and liver metastasis [36.0%(18/50) vs. 2.6%(12/462), χ(2)=4.20, P<0.01]. The median survival time of AFP positive and negative groups was 30 months and 42 months, the 5-year survival rate was 20.8% and 27.5%, respectively(P<0.05). Univariate analysis showed that AFP level, tumor size, tumor infiltration, lymphatic metastasis, pathological stage, liver metastasis and vascular tumor invasion were risk factors influencing the prognosis of AFP positive gastric cancer(P<0.05). Cox analysis showed that the independent prognostic factors included tumor infiltration (HR=1.464, 95% CI: 1.068-2.007, P=0.018), lymphatic metastasis (HR=1.136, 95% CI: 1.011-1.275, P=0.032) and liver metastasis (HR=4.116, 95% CI: 2.610-6.489, P=0.000), but not AFP level(P>0.05).

CONCLUSIONGastric cancer patients with positive serum AFP usually present vascular tumor invasion and liver metastasis, but AFP level is not the independent prognostic factor.