The Clinicopathological Characteristics, Proliferative Activity and Formation of Basement Membrane of Gastric Cancer with High Serum Level of α-fetoprotein

Katsuyuki Kunieda, Shigetoyo Saji, Yoshihiro Kawaguchi, Motohisa Katoh, Yasuyuki Sugiyama, Takao Umenoto, Kiichi Miya, Daizo Fukada, Kiyoshi Inada*, Kuniyasu Shimokawa*

Second Department of Surgery, The Department of Laboratory Medicine*, Gifu University School of Medicine

We studied the clinicopathological characteristics, cell proliferating activity and the formation of a basement membrane by immunohistochemical staining, using a proliferating cell nuclear antigen (PCNA) monoclonal antibody and an anti-laminin monoclonal antibody, in gastric cancer patients showing elevation of serum α-fetoprotein. The subjects were 16 patients consisting of 5 with stages Ia+Ib, 1 with stage II, 3 with stages IIIa+IIIb and 7 with stages IVa+IVb. Eight patients (50%) showed type 2 of macroscopic type and 12 cancers were located in the distal part of the stomach. Poor medullary type was significantly predominant in the high AFP group. Six patients (37.5%) had synchronous liver metastases and 3 showed metachronous metastases. The frequency of liver metastasis in the high AFP group was significantly higher than in the low AFP group. The 5 year survival rate was 25.0%, and 2 patients with stage Ia and II died of liver metastasis. The rate of positive tissue AFP staining was 81.3%. The PCNA-labeling index in the high AFP group (63.9%) was significantly higher than in the low AFP group (44.1%). The rate of positive laminin staining in the high AFP group was significantly higher than that in the low AFP group. From the above results, it is sugested that the proliferative activity and frequency of formation of a basement membrane in gastric cancer patients with elevation of serum AFP are higher than those in AFP-negative gastric cancer patients. It is also suggested that these characteristics have some relationship with a high frequency of liver metastasis.

Reprint requests
Katsuyuki Kunieda Second Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
July 2, 1997

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