摘要
AFP阳性胃癌（alpha-fetoprotein-producing gastric carcinoma，APGC）发病率文献统计占胃癌的5．1％～15％。其临床病理学特征与普通型胃癌有较大不同，更易发生肝转移和早期淋巴道转移，具有明显的侵袭性和恶性生物学行为，被认为是一个独立的预后因素。了解APGC高侵袭性的分子作用机制对于今后制定出新的诊断治疗方案有着重要的意义。然而，APF的升高与APGC的高侵袭性之间的关系尚不明确。APGC患者血清及肿瘤组织中AFP与血管内皮细胞生长因子（vascular endothelial growth factor，VEGF）和肝细胞生长因子受体C（c-Met）等与肿瘤侵袭性密切相关的基因表达水平呈正相关，而APGC中AT motif binding factorl（ATBF1）等抑癌基因表达水平低于普通型胃癌。这些基因和其他目前尚未明确的因素可能共同参与了APGC高侵袭性的分子作用机制。APGC治疗首选胃癌根治术，无法切除的转移灶，应积极给予化疗等综合措施治疗，但仍有待发现更新的APGC综合治疗模式。总结了APGC的临床病理、分子生物学特点及治疗等方面的进展。
AFP-producing gastric cancer comprises 5.1%- 15% of cancers derived from stomach epithelia,has aggressive behavior and malignant biologic activity, and its clinical or biological features are quite different from the common AFP-negative gastric cancers. It shows a high incidence of liver and early lymph node metastases. It is regarded as an independent prognostic factor of gastric cancers. The study of its clinical or biological features and molecular biology is badly needed for the development of an early detection and novel multimodal therapies against AFP-produeing gastric cancers. However, the causal relationship between AFP production and the high malignancy of APGC is unclear. There are correlations among the expressions of AFP, VEGF and c-Met in APGC. They are involved in the mechanism of progression and metastasis. The expression of antioneogene, such as AT motif binding factorl （ATBF1）is lower than that in stage-matched gastric cancers not producing AFP. These factors, together with other asyet-unidentified factors, are probably involved in the high invasiveness and metastatic potential of APGC. Curative gastreetomy is the primary choice of treatment. Regimens of adjuvant chemotherapy are recommended. Howerer, the development of a novel multi-modal therapy against APGC is needed. The purpose of the present study was to clarify the development of the clinieopathologieal features, cellular or molecular characteristics and the treatment of these cancers.
出处
《中华肿瘤防治杂志》
CAS
2006年第7期552-555,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省自然科学基金Z2003C01
关键词
胃肿瘤/病理学
甲胎蛋白类
综述文献
stomach neoplasms/pathology
alpha-fetoproteins
review literature
作者简介
宋玉环，女，山东成武人，主要从事消化系肿瘤的研究工作。现于北京航天中心医院工作。Tel：86—531—88380223 E-mail：ailili800129@163．com
【通讯作者简介】汪运山，男，山东平邑人，硕士，教授，主任医师，硕士生导师，主要从事肿瘤免疫和肿瘤分子生物学研究工作。Tel：86—531—86557322 E-mail：sdjnwys@163．com
