Tags

Type your tag names separated by a space and hit enter

Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases.

Abstract

Background:

High serum levels of alpha-fetoprotein (AFP) are observed in some gastrointestinal cancers. However, primary AFP-producing colorectal cancer (CRC) is extremely rare and causes confusion among clinicians. In this study, we analyzed the clinicopathological features and clinical outcomes of AFP-producing CRC and provide a brief view of this rare carcinoma. Patients and methods: Twenty patients with AFP-producing CRC were enrolled at the Fudan University Shanghai Cancer Center from 2012 to 2015. Clinical information, including serum AFP and CEA levels, and outcomes were collected. Tumors were divided into three histologic types: the common adenocarcinoma (COM) type, mucinous adenocarcinoma type and hepatoid type (HPT). Immunohistochemical (IHC) staining of GPC3, Hepa-1, SALL4 and Arg-1 was performed. Additionally, mutations of the KRAS, NRAS and BRAF genes were examined. Finally, another 40 stage-matched patients with traditional CRC were enrolled as controls for survival analysis.

Results:

AFP-producing CRC was more likely to occur in males (60%) and arose mainly from the ascending (40%) and sigmoid (35%) colon. In addition, the majority of patients with AFP-producing CRC had poor differentiation (50%), advanced local invasion (80%) and lymph node (LN) metastasis (60%). Synchronous distant metastasis was commonly observed (35%). Interestingly, serum AFP levels were closely associated with LN metastasis. Histopathologically, the COM type was the most common pattern. In IHC staining, the HPT pattern was the most distinct due to high positivity rates of GPC3, Hepa-1 and Arg-1. One patient had mismatch repair deficiency, and another had a KRAS mutation. Patients with AFP-producing CRC had worse progression-free and overall survival than patients with traditional CRC.

Conclusion:

AFP-producing CRC has unique clinical and histopathological characteristics, showing an aggressive biological behavior and worse prognosis than traditional CRC.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    ,

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

    Source

    Cancer management and research 11: 2019 pg 4557-4567

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31191017

    Citation

    Ren, Fei, et al. "Clinicopathological Features and Prognosis of AFP-producing Colorectal Cancer: a Single-center Analysis of 20 Cases." Cancer Management and Research, vol. 11, 2019, pp. 4557-4567.
    Ren F, Weng W, Zhang Q, et al. Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases. Cancer Manag Res. 2019;11:4557-4567.
    Ren, F., Weng, W., Zhang, Q., Tan, C., Xu, M., Zhang, M., ... Huang, D. (2019). Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases. Cancer Management and Research, 11, pp. 4557-4567. doi:10.2147/CMAR.S196919.
    Ren F, et al. Clinicopathological Features and Prognosis of AFP-producing Colorectal Cancer: a Single-center Analysis of 20 Cases. Cancer Manag Res. 2019;11:4557-4567. PubMed PMID: 31191017.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinicopathological features and prognosis of AFP-producing colorectal cancer: a single-center analysis of 20 cases. AU - Ren,Fei, AU - Weng,Weiwei, AU - Zhang,Qiongyan, AU - Tan,Cong, AU - Xu,Midie, AU - Zhang,Meng, AU - Wang,Lei, AU - Sheng,Weiqi, AU - Ni,Shujuan, AU - Huang,Dan, Y1 - 2019/05/16/ PY - 2018/12/04/received PY - 2019/04/12/accepted PY - 2019/6/14/entrez PY - 2019/6/14/pubmed PY - 2019/6/14/medline KW - AFP-producing colorectal cancer KW - clinicopathological features KW - prognosis KW - serum AFP SP - 4557 EP - 4567 JF - Cancer management and research JO - Cancer Manag Res VL - 11 N2 - Background: High serum levels of alpha-fetoprotein (AFP) are observed in some gastrointestinal cancers. However, primary AFP-producing colorectal cancer (CRC) is extremely rare and causes confusion among clinicians. In this study, we analyzed the clinicopathological features and clinical outcomes of AFP-producing CRC and provide a brief view of this rare carcinoma. Patients and methods: Twenty patients with AFP-producing CRC were enrolled at the Fudan University Shanghai Cancer Center from 2012 to 2015. Clinical information, including serum AFP and CEA levels, and outcomes were collected. Tumors were divided into three histologic types: the common adenocarcinoma (COM) type, mucinous adenocarcinoma type and hepatoid type (HPT). Immunohistochemical (IHC) staining of GPC3, Hepa-1, SALL4 and Arg-1 was performed. Additionally, mutations of the KRAS, NRAS and BRAF genes were examined. Finally, another 40 stage-matched patients with traditional CRC were enrolled as controls for survival analysis. Results: AFP-producing CRC was more likely to occur in males (60%) and arose mainly from the ascending (40%) and sigmoid (35%) colon. In addition, the majority of patients with AFP-producing CRC had poor differentiation (50%), advanced local invasion (80%) and lymph node (LN) metastasis (60%). Synchronous distant metastasis was commonly observed (35%). Interestingly, serum AFP levels were closely associated with LN metastasis. Histopathologically, the COM type was the most common pattern. In IHC staining, the HPT pattern was the most distinct due to high positivity rates of GPC3, Hepa-1 and Arg-1. One patient had mismatch repair deficiency, and another had a KRAS mutation. Patients with AFP-producing CRC had worse progression-free and overall survival than patients with traditional CRC. Conclusion: AFP-producing CRC has unique clinical and histopathological characteristics, showing an aggressive biological behavior and worse prognosis than traditional CRC. SN - 1179-1322 UR - https://www.unboundmedicine.com/medline/citation/31191017/Clinicopathological_features_and_prognosis_of_AFP-producing_colorectal_cancer:_a_single-center_analysis_of_20_cases L2 - https://dx.doi.org/10.2147/CMAR.S196919 DB - PRIME DP - Unbound Medicine ER -