Objective To discuss the clinical manifestations, diagnosis, and treatment of hepatoid adenocarcinoma of the stomach. Methods By summarizing the multi-disciplinary team results of 1 patient with hepatoid adenocarcinoma of the stomach, who underwent surgery in West China Hospital in October 2017, as well as reviewing the related literatures, to explore the clinicopathological features of hepatoid adenocarcinoma of the stomach. Results The clinical features of hepatoid adenocarcinoma of the stomach were often accompanied by early liver metastasis and alpha fetoprotein (AFP) significantly increased, which were easily misdiagnosed as primary hepatocellular carcinoma. The histopathological features of hepatoid adenocarcinoma of the stomach were characterized by two structures: hepatocellular carcinoma and adenocarcinoma. Conclusion Hepatoid adenocarcinoma of the stomach is a special type of gastric adenocarcinoma, and radical operation is the main treatment, but the prognosis of it is poor.
Objective To detect expression of miR-483-5p in surem of patients with hepatocellular carcinoma (HCC) and investigate it’s clinical significance for diagnosis of HCC. Methods The rerum samples of 112 patients with HCC (HCC group), 85 patients with chronic viral hepatitis B (CHB group), and 56 healthy people for physical examination (healthy control group) were collected from January 2010 to January 2012 in the First Hospital of Lanzhou University. According to the results of preliminary chip detection of miRCURY LNATM miRNA, the real-time fluorescent quantitative PCR was adopted to quantitate the serum levels of miR-483-5p and miR-500a and the routine electrochemical method was used to detect the serum alpha fetoprotein (AFP) in every group. The receiver operating characteristic (ROC) curve was utilized to analyze the diagnostic values of serum miR-483-5p, miR-500a, and AFP for the HCC. Results The serum levels of miR-483-5p and miR-500a in the HCC group were significantly higher than those of the CHB and healthy control groups (both P<0.000 1), which had no significant differences between the CHB group and the healthy control group (P>0.05). The serum miR-483-5p level of the HCC patient decreased markedly at the postoperative 30 d (P<0.000 1) as compared with the preoperative level. The area under the ROC curve (AUC) of miR-483-5p, miR-500a, AFP, or miR-483-5p in combination with AFP for the diagnosis of the HCC was 0.74 (cutoff value=2.842, sensitivity=74% and specificity=66%), 0.66 (cutoff value=1.830, sensitivity=74% and specificity=51%), 0.81 (cutoff value=20 μg/L, sensitivity=78% and specificity=70%), and 0.92 (cutoff value=3.78, sensitivity=81% and specificity=83%), respectively. The AUC values of miR-483-5p in the diagnosis of the HCC patients with positive AFP (AFP>20 μg/L) and negative AFP (0–20 μg/L) were 0.78 and 0.83, respectively. Conclusions Serum miR-483-5p highly expresses in HCC, which has a certain accuracy in diagnosis of HCC, it combined with AFP could further increase its diagnostic value. Serum miR-483-5p might play an important supplemental role in diagnosis of HCC patient with negative AFP.
Objective To study the effect of alpha fetoprotein-tumor burden score (ATS) on the long-term prognosis of hepatocellular carcinoma (HCC) after resection. MethodsThe data of 2 907 patients with HCC who underwent first hepatectomy from West China Hospital of Sichuan University, West China Ziyang Hospital/Ziyang Central Hospital, The First People’s Hospital of Neijiang, West China Yibin Hospital/The Second People’s Hospital of Yibin between 2015 and 2022, were retrospectively analyzed. The X-tile software was used to calculate the optimal truncation of the ATS score. Cox proportional hazard regression model was used to explore risk factors affecting postoperative recurrence-free survival (RFS) and overall survival (OS) in HCC patients, respectively. ResultsAll patients were followed-up with a median of 37 months, 1 364 cases (46.9%, the recurrence time was 1–89 months after surgery) of them experienced recurrence and 841 cases (29.1%) died (the death time was 1–88 months after surgery). The 1-, 2- and 3-year OS rates were 89.3%, 81.4% and 75.9%, respectively. The 1-, 2- and 3-year RFS rates were 76.0%, 64.3% and 57.2%, respectively. The 5-year RFS rate of HCC patients with low-, medium-, and high-ATS scores were 56.4%, 45.0% and 27.2%, respectively, and patients with low ATS score had better RFS (χ2=264.747, P<0.001). The 5-year OS rate of HCC patients with low-, medium-, and high- ATS scores were 78.0%, 59.8% and 38.8%, respectively, and patients with low-ATS score had better OS (χ2=372.685, P<0.001). Multivariate Cox proportional hazard regression model suggested that, in condition of adjusting gender, age, liver function, microvascular invasion, tumor differentiation, and BCLC stage, medium-ATS score [RR=1.375, 95%CI (1.209, 1.564), P=0.005] and high-ATS score [RR=2.048, 95%CI (1.764, 2.377), P<0.001] were risk factors for postoperative RFS; the medium-ATS score [RR=1.779, 95%CI (1.499, 2.112), P<0.001] and high ATS score [RR=2.676, 95%CI (2.211, 3.239), P<0.001] were also risk factors affecting postoperative OS. ConclusionATS score can predict the prognosis of HCC patients after resection, patients with high ATS scores had a higher incidence of postoperative recurrence and mortality.