Background:alpha-fetoprotein-producing gastric cancer(AFPGC)is relatively rare and special type of gastric cancer,and its clinical symptoms are lack specificity.Aims:To summarize the clinical characteristics and prognosis of AFPGC.Methods:The data of patients with AFPGC from July 2017 to June 2023 at Shaanxi Provincial People's Hospital were retrospectively analyzed,including clinical manifestations,laboratory and examination results,endoscopic results,pathology and treatment.Results:In 17 patients with AFPGC,14 were male and 3 were female.The clinical manifestations were mainly abdominal pain,hematochezia,upper abdominal discomfort,fatigue,etc.AFP was 200-2000 ng/mL.The laboratory examination tests showed that anemia in 16 patients,elevated CEA in 1 patient,abnormal liver function in 2 patients,Hepatitis B Virus-positive in 1 patient,CT showed liver metastasis in 11 patients,lymph node metastasis in 12 patients,cirrhosis in 1 patient.Conclusions:For patients with gastric cancer indicated by examination,if AFP is elevated,AFPGC should be considered.Early detection and surgical treatment can improve the prognosis of AFPGC.

Background:alpha-fetoprotein-producing gastric cancer(AFPGC)is relatively rare and special type of gastric cancer,and its clinical symptoms are lack specificity.Aims:To summarize the clinical characteristics and prognosis of AFPGC.Methods:The data of patients with AFPGC from July 2017 to June 2023 at Shaanxi Provincial People's Hospital were retrospectively analyzed,including clinical manifestations,laboratory and examination results,endoscopic results,pathology and treatment.Results:In 17 patients with AFPGC,14 were male and 3 were female.The clinical manifestations were mainly abdominal pain,hematochezia,upper abdominal discomfort,fatigue,etc.AFP was 200-2000 ng/mL.The laboratory examination tests showed that anemia in 16 patients,elevated CEA in 1 patient,abnormal liver function in 2 patients,Hepatitis B Virus-positive in 1 patient,CT showed liver metastasis in 11 patients,lymph node metastasis in 12 patients,cirrhosis in 1 patient.Conclusions:For patients with gastric cancer indicated by examination,if AFP is elevated,AFPGC should be considered.Early detection and surgical treatment can improve the prognosis of AFPGC.

ObjectiveTo evaluate the safety and effectiveness of fast track surgery (FTS) in l aparoscopy-assisted radical distal gastrectomy (LADG) for gastric cancer.MethodsSixty-one patientswith distal gastric cancer were randomly divided into three groups:FTS + LADG group (n =19) undergoing LADG and FTS treatments,LADG group (n =22) undergoing LADG and traditional perioperative cares,and FTS + ODG ( open distal gastrectomy) group ( n =21 ) undergoing ODG and FTS treatments.FTS treatments included avoidance of mechanical bowel cleansing,restrictive perioperative intravenous infusion,early ambulation,early enteral nutrition.The age,sex,body weight,anastomotic mode,number of lymph node dissected,and tumor stage,serum albumin (ALB),blood urea nitrogen (BUN),C-reaction protein (CRP),flatus time,postoperative hospital stay,medical cost,and postoperative complications were compared between three groups. ResultsThe level of ALB in FTS + LADG group were higher than in LADG group at the 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.01 ).Compared to LADG group,the variation of ALB from preoperation to 4th day after surgery in FTS + LADG group and FTS + ODG group was significant( P ＜ 0.01,P ＜ 0.05 ).CRP level between FTS + LADG group and FTS + ODG group were different significantly at 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.05).FTS + LADG group has earlier recovery of gastrointestinal peristalsis than other two groups ( P ＜ 0.05,P ＜ 0.05 ).The medical cost in FTS + LADG group was less than in LADG group ( P =0.003 ),but higher than in FTS + ODG group (P ＜0.01 ).ConclusionsThe practice of FTS in LADG was safe,effective,improves nutritional status,eases stress reaction,accelerates gastrointestinal peristalsis and postoperative rehabilitation.