Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

Table 1 Clinicopathological findings for patients with gastric cancer with enteroblastic differentiation

Case	1	2	3	4	5	6
Age, yr	61	77	78	75	80	83
Male/female	Male	Male	Male	Male	Female	Male
Tumor location: U/M/L	L	M	U	U	L	M
Tumor size, mm	8	11	14	18	6	36
Macroscopic type	0-IIc	0-IIc	0-IIc	0-IIa	0-IIc	0-IIa + I
H. pylori infection	HPIgG+	HPIgG+	HPIgG-	NA	HPIgG+	HPIgG+
Procedure method	ESD	ESD	ESD with additional surgery	ESD	ESD	ESD with additional surgery
Depth of invasion (μm)	M	SM (1500)	SM (1000)	SM (200)	M	SM (2000)
Lymphatic invasion	(-)	(-)	(-)	(-)	(+)	(+)
Venous invasion	(-)	(+)	(+)	(+)	(-)	(+)
Observation period (mo)	51, ANED	42, ANED	N/A	38, ANED	N/A	28, ANED
Immunohistochemical analysis
AFP	(+)	(-)	(-)	(-)	(-)	(-)
Glypican3	(+)	(+)	(+)	(+)	(-)	(+)
SALL4	(+)	(-)	(-)	(-)	(+)	(-)
MUC2	(-)	(-)	(-)	(+)	(-)	(-)
MUC5AC	(-)	(-)	(-)	(+)	(-)	(-)
MUC6	(-)	(+)	(+)	(+)	(-)	(+)
CD10	(+)	(+)	(+)	(+)	(+)	(+)
P53	(-)	(-)	(+)	(+)	(+)	(-)

U: Upper third of stomach; M: Middle third of stomach; L: Lower third of stomach; H. pylori: Helicobacter pylori; IgG: Immunoglobulin G; ESD: Endoscopic submucosal dissection; M: Mucosa; SM: Submucosa; ANED: Alive with no evidence of disease; N/A: Not applicable; AFP: Alpha-fetoprotein.

Table 2 Results of comparison between patients with gastric cancer with enteroblastic differentiation and conventional gastric cancer n (%)

	GCED	CGC	P value
Number of lesions, n	6 (2.7)	209 (97.3)	N/A
Age, yr; median (range)	75.7 (61-83)	72.7 (40-92)	0.39
Male/female	5/1	139/47	0.63
Tumor location: U/M/L	2/2/2	23/91/95	0.24
Tumor size, mm, mean (range)	15.0 (6-36)	15.2 (2-60)	0.96
Macroscopic type: elevated type/flat or depressed type	2/4	92/117	0.60
Ulceration	0	19 (9.0)	0.43
Depth of invasion: M/SM	2/4	185/24	< 0.01
Rate of submucosal invasive cancer	66.60%	11.40%
Median SM invasive depth, μm (range)	1500(200-2000)	795.8(100-5000)	0.40
Lymphatic invasion	2 (33.3)	5 (2.3)	< 0.01
Venous invasion	4 (66.6)	1 (0.4)	< 0.01
Positive horizontal margin	0	9 (4.3)	0.60
Positive vertical margin	1 (16.7)	5 (2.3)	< 0.05
Curative resection1	1 (16.7)	186 (89.0)	< 0.01
The following is a comparison only for SM invasive cancer
Number of SM invasive lesions, n	4	24	N/A
Lymphatic invasion	1 (25)	5 (20.8)	0.88
Venous invasion	4 (100)	1 (4.2)	< 0.01
Positive horizontal margin	0	1 (4.2)	0.33
Positive vertical margin	1 (16.7)	2 (8.3)	0.55
Curative resection1	0	12 (50)	< 0.01

¹Curative resection was according to Gastric Cancer Treatment Guidelines 2010 or 2014 provided by the Japanese Gastric Cancer Association. GCED: Gastric cancer with enteroblastic differentiation; CGC: Conventional gastric cancer (well or moderately differentiated carcinoma); U: Upper third of stomach; M: Middle third of stomach; L: Lower third of stomach; M: Mucosa; SM: Submucosa.