alpha-fetoprotein産生早期胃癌の1例

Alpha-fetoprotein Producing Early Gastric Cancer, Report of a Case

要旨　患者は61歳の男性．症状はなく，健康診断により胃の潰瘍性病変を発見された．術前検査にて，血清alpha-fetoprotein（以下AFP）が51.2ng/mlと高値を呈していた．肝機能検査上，異常は認められなかった．胃癌の診断のもと，胃切除が施行された．病変は，幽門前庭部小彎のⅡa＋Ⅱc型早期胃癌（sm）で，低分化腺癌であり，胎児性癌に類似した部分も見られた．肝転移，腹膜播種，リンパ節転移は認めなかった．免疫組織化学的検査にて，AFPが腫瘍細胞内に証明された．術後，AFPは正常域に復し，1年6か月後も再発の所見なく健在である．AFP産生胃癌の報告は多いが，早期胃癌は非常にまれと思われ，報告した．

　A 61-year-old male was admitted to our hospital for gastric cancer resection. His disease was found by annual upper GI x-ray examinations for screening. Preoperative serum alpha-fetoprotein (AFP) level was 51.2ng/ml. Gastrectomy was performed on May 29, 1991. The cancer, macroscopically type Ⅱa+Ⅱc, was located in the antral region. Microscopic examination showed that the main portion of the tumor was poorly differentiated adenocarcinoma but some parts of the lesion were mimicking embryonal carcinoma. Immunohistochemically, AFP was identified in the cytoplasm of the tumor cells. No metastasis was found. Postoperative course was uneventful. The AFP level returned to the normal range after the operation. He had been well without any evidence of recurrence for one year and a half after the surgery.