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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1514069

Dual-positive gastric cancer: An extremely malignant subtype of gastric cancer with high serum alpha-fetoprotein and carcinoembryonic antigen concentrations

Provisionally accepted
Weixun Xie Weixun Xie 1Chengyu Hu Chengyu Hu 1Hongming Liu Hongming Liu 1Zelai Wu Zelai Wu 1Bixian Luo Bixian Luo 1Xiaoying Wu Xiaoying Wu 2Han Liu Han Liu 1Chuanlei Tuo Chuanlei Tuo 3Ziyin Deng Ziyin Deng 3Han Liang Han Liang 3Yong Liu Yong Liu 3*Weihua Gong Weihua Gong 1*
  • 1 Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  • 2 Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, China
  • 3 National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, Tianjin Municipality, China

The final, formatted version of the article will be published soon.

    Alpha-fetoprotein-producing gastric cancer (AFPGC) is a highly malignant subtype of gastric cancer, but solely alpha-fetoprotein may fail to accurately predict the prognosis. Although the utilization of multi tumor markers could improve stratified patient management, such research in AFPGC is still blank. To assess whether combining multiple tumor markers can improve risk stratification and identify AFPGC subtypes with poor prognosis.We first screened for patients with elevated serum CEA levels within the AFPGC cohort and evaluated their prognosis. Tumor characteristics and overall health conditions were analyzed to identify factors contributing to CEA elevation. Finally, the treatment responses of this group to different treatment modalities were also reviewed.Approximately 45% of gastric cancer patients with elevated serum AFP also show increased CEA levels, classifying them as the dual-positive gastric cancer (DPGC) subgroup. These patients exhibit significantly shorter overall survival, heightened metastasis risk, and are more susceptible to systemic inflammation, immune response dysregulation, malnutrition, and cancer-related thrombosis. The elevation in serum CEA levels may indicate gastric cancer liver metastasis and increased neutrophils. While surgery is optimal for AFPGC, DPGC patients benefit significantly from immunotherapy combined with chemotherapy.In AFPGC, combining serum AFP and CEA offers a more accurate prognosis. The poor prognosis in DPGC may be associated with aggressive local properties and systemic complications. Liver metastases and increased neutrophils are associated with increased serum CEA in AFPGC. Immunochemotherapy is a viable option for DPGC patients who cannot undergo surgery.

    Keywords: gastric cancer, AFPGC, AFP, CEA, chemotherapy

    Received: 19 Oct 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Xie, Hu, Liu, Wu, Luo, Wu, Liu, Tuo, Deng, Liang, Liu and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yong Liu, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300070, Tianjin Municipality, China
    Weihua Gong, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

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