肝樣胃癌的臨床病理特征預(yù)后及研究展望演示文稿當(dāng)前1頁，總共28頁。（優(yōu)選）肝樣胃癌的臨床病理特征預(yù)后及研究展望當(dāng)前2頁，總共28頁。新生幼稚肝細(xì)胞（未分化完全）分泌AFP量很大

肝癌細(xì)胞（尚未分化的肝細(xì)胞）當(dāng)前3頁，總共28頁。80-90%Hcc患者血清AFP增高肝細(xì)胞癌Hcc—90%肝外膽管細(xì)胞癌Hcc—10%原發(fā)性肝癌當(dāng)前4頁，總共28頁。甲胎蛋白是診斷原發(fā)性肝癌的一個特異性臨床指標(biāo)。However!!EXCEPTION!!當(dāng)前5頁，總共28頁。!!EXCEPTION!!部分肝硬化病人會長期出現(xiàn)AFP達(dá)到上千，但多年都沒有肝癌的跡象。同時發(fā)現(xiàn)約20%的晚期肝癌病人，直至病故前，AFP仍不超過10。

AFP與腫瘤大小有一定的相關(guān)性，即腫瘤越小，陽性率越低。AFP也與病理類型相關(guān)，癌細(xì)胞分化I級和II級，AFP相對較低，Ⅲ級時相對較高。SomereportsshowedthatAFPcouldalsobeproducedbygastrointestinaltractorgans,rectalcarcinoma,gallbladdercarcinoma,lungcarcinoma,andbladdercancer.當(dāng)前6頁，總共28頁。血清甲胎蛋白增高的原因

肝癌（陽性率80-90%）隨著病情惡化它在血清中的含量會急劇增加

急性肝炎慢性肝炎肝硬化孕婦;其他腫瘤的肝轉(zhuǎn)移一過性升高隨著病情的恢復(fù)，血清甲胎蛋白值會下降

生殖細(xì)胞腫瘤陽性率50%AFP陽性當(dāng)前7頁，總共28頁。alpha-fetoprotein-producinggastriccancer(AFPGC)Hepatoidadenocarcinomaofthestomach(HAS)當(dāng)前8頁，總共28頁。Concept:

alpha-fetoprotein-producinggastriccancer(AFPPGC)Atpresenttime,itwasgenerallyacceptedthatthediagnosticcriteriaofAFP-producinggastriccancerwaspositivestainingofAFPinprimarylesionregardlessofserumAFPlevel當(dāng)前9頁，總共28頁。ConceptofHAS1.Hepatoidadenocarcinomaisakindofextrahepatictumorpresentingmorphologicalareasidenticaltothatofhepatocellularcarcinomas.2.Inadditiontothehistologicalsimilarity,itcanalsoproduceAFP-likehepatocellularcarcinomas當(dāng)前10頁，總共28頁。當(dāng)前11頁，總共28頁。PatientsCharacteristics當(dāng)前12頁，總共28頁。當(dāng)前13頁，總共28頁。NoCorrelationAnalysis當(dāng)前14頁，總共28頁。當(dāng)前15頁，總共28頁。我們科室AFPPGC與對照胃癌患者的總生存比較當(dāng)前16頁，總共28頁。當(dāng)前17頁，總共28頁。當(dāng)前18頁，總共28頁。當(dāng)前19頁，總共28頁。當(dāng)前20頁，總共28頁。當(dāng)前21頁，總共28頁。當(dāng)前22頁，總共28頁。49.2%11.5%75.6%當(dāng)前23頁，總共28頁。當(dāng)前24頁，總共28頁。AFPPGCandHAShadmoreaggressivebehaviorandpoorerprognosisthanCGC.HASirrespectiveofAFPproductionhaveapoorerprognosisthanAFP-producinggastriccarcinomaswithouthepatoiddifferentiationHASshouldbedistinguishedfromAFPPGC.Conclusion當(dāng)前25頁，總共28頁。Why:HASmeanspoorprognosis?ItwasproposedthatsomesecretoryproteinslikeAFPhadimmunosuppressiveandprotease-inhibitoryproperties,thereforeenhancedinvasiveness.Theexactmolecularmechanismthatcouldexplainaggressivebehaviorwasstillnotclear.Somepreviousresearchesshowedthattheintegrityofhepatocytegrowthfactor(HGF)receptor(c-Met)andligandasHGFcouldregulatecellproliferationandmigration.Amemiyaetal.Foundthatc-Metover-expressedfrequentlyinAFP-producinggastriccancersthaninstage-matchedgastriccancersthatdidnotproduceAFP.TheseresultssuggestedthataggressivebehaviorofAFP-producinggastriccancermaybeassociatedwithover-expressedc-Met.Targetgeneofpoorbiologicalbehaviorandeasytolivermetastasis?當(dāng)前26頁，總共28頁。AFPinclinicaluse:

CanAFPberoutinelycheckedincircularbloo