UNASSIGNED: Despite the remarkable progress in minimally invasive surgery, the potential association between laparoscopic gastrectomy and the risk of peritoneal metastasis remains uncertain.
UNASSIGNED: To investigate variations in tumour markers in intraperitoneal drainage fluid between laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer.
UNASSIGNED: A total of 106 patients diagnosed with gastric cancer between July 2018 and November 2020 were included in this study, 45 of whom underwent laparoscopic radical gastrectomy (laparoscopic group) and 61 underwent open radical gastrectomy (open group). Variations in the levels of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 199 (CA199), and α-fetoprotein (AFP) in the intraperitoneal drainage fluid were compared and analysed on postoperative days (PODs) 1, 2, 3, and 5 between the two groups. Additionally, the postoperative 3-year survival rates between the two groups were compared and analysed.
UNASSIGNED: No significant differences in CEA, CA199, and AFP levels in the intraperitoneal drainage fluid were observed between the two groups on postoperative days (PODs) 1, 2, 3, and 5 (p > 0.05). However, the level of CA125 in the intraperitoneal drainage fluid of the laparoscopic group was notably higher than that of the open group on POD 2 (p < 0.05); however, there were no significant differences between the two groups on PODs 1, 3, and 5 (p > 0.05). There was no significant difference in the 3-year postoperative survival rates between the two groups.
UNASSIGNED: There were no significant differences in CEA, CA125, CA199, and AFP levels in the intraperitoneal drainage fluid between laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer, confirming from another perspective that laparoscopic radical gastrectomy does not increase the risk of intraperitoneal metastasis.

α-Fetoprotein (AFP)-producing gastric carcinoma (GC) (AFPGC) is a special subtype of GC that is clinically characterized by a high incidence of liver metastasis and poor prognosis. The present study reported the case of a patient with AFPGC who showed complete response (CR) after stereotactic body radiotherapy (SBRT) for liver metastasis. A 76-year-old male patient underwent total gastrectomy with D2 lymph node dissection for GC. The excised tumor was diagnosed as AFPGC due to the patient\'s high serum AFP level (3,763 ng/ml) and AFP expression on immunohistochemistry. The patient was diagnosed with liver metastasis two months after the surgery. 18F-fluorodeoxyglucose positron emission tomography indicated that the metastasis was a single recurrent focus. Although the patient underwent seven cycles of chemotherapy with S-1-based regimens, the metastatic tumor showed only a minor response despite the decrease in serum AFP levels. To realize high-quality disease control, SBRT was performed on the liver tumor (total dose of 48 Gy in four fractions). The metastasis showed a significant response two weeks after the completion of SBRT and CR two years later. CR was sustained and the patient survived with no evidence of recurrence 62 months after the diagnosis of liver metastasis. Literature data on the efficacy of radiotherapy for liver metastasis from AFPGC remain scarce. The present case report suggests that SBRT has high efficacy for oligometastatic diseases and may be included as an indication for the treatment of liver metastasis from AFPGC.

UNASSIGNED: Acute liver failure (ALF) is a severe complication of spontaneous ruptured hepatocellular carcinoma (SRHCC) that requires accurate prediction for effective treatment strategies. We aimed to develop a predictive nomogram to estimate the risk of ALF in patients with SRHCC undergoing treatment.
UNASSIGNED: We performed a retrospective analysis of historical data from 284 patients diagnosed with SRHCC at the First Hospital of Jilin University over the past decade. Variables were selected through univariate and multivariate logistic regression analyses, and a predictive nomogram was constructed. We evaluated its predictive accuracy against the Child-Pugh Score, R.MELD, and ALBI by assessing discrimination, calibration, and net clinical benefit.
UNASSIGNED: Among the 284 patients, 65 developed ALF. The risk factors identified for model development included largest tumor size (LTS), platelet counts, prolonged prothrombin time, and elevated serum α-fetoprotein levels. The nomogram exhibited high accuracy in predicting ALF risk with a C-index of 0.91 (0.87-0.95). The Delong test showed a significant difference between the nomogram and the other three models (p<0.05). The calibration curve for the nomogram fit well, and the decision curve analysis revealed superior net benefit. The optimal cut-off point for the nomogram was determined to be 40, yielding sensitivity, specificity, positive predictive value, and negative predictive value of 83.10%, 87.20%, 65.90% and 94.60%, respectively.
UNASSIGNED: The nomogram we developed provides an optimized tool for predicting ALF in SRHCC patients. Its application can help determine individual patient\'s risk of ALF, enabling more rational and personalized treatment strategies.

This study aimed to investigate whether α-fetoprotein (AFP) could affect the malignant behavior of AFP-producing gastric cancer (AFP-GC) and to explore the relationship between AFP and mesenchymal-epithelial transition factor (c-Met) in AFP-GC. In this study, 23 patients with AFP-GC (AFP[+]) and 18 patients with common gastric cancer (AFP[-]) were evaluated for the c-Met expression using immunohistochemical analysis. The AFP-GC cell line, GCIY, was used. The AFP endoribonuclease-prepared small interfering RNA (siRNA) and eukaryotic AFP overexpression vector were used to increase/knockdown the expression of AFP. Afterward, the c-Met expression was evaluated by polymerase chain reaction and western blot. The proliferation, migration, and invasion of GCIY cells were estimated before and after the AFP overexpression/knockdown. The c-Met expression in both groups was the same (p > 0.05), and AFP[+] group had a higher positive incidence of the c-Met expression than the AFP[-] group (p < 0.01). Furthermore, the c-Met expression frequency was decreased by AFP knockdown and increased by AFP overexpression (p < 0.01). The cell counting kit-8 cell proliferation assay, cell invasion, and migration assays confirmed that the AFP could affect the malignant biological behavior of AFP-GC. These findings suggest that AFP contributes to the malignant biological properties of AFP-GC and the high expression of c-Met in AFP-GC.

UNASSIGNED: Transarterial chemoembolization (TACE) is the recommended first-line treatment for intermediate-stage Hepatocellular carcinoma (HCC) patients. However, predicting the survival of HCC patients receiving TACE remains challenging.
UNASSIGNED: In this retrospective study, we analyzed a total of 1805 HCC patients who received TACE. The patients were randomly divided into a training set (n = 1264) and a validation set (n = 541). We examined various prognostic factors within the training set and developed a simple ALFP (ALBI grade, AFP, and Prothrombin time) score, which was subsequently validated using the independent validation set.
UNASSIGNED: Our multivariate analysis revealed that baseline ALBI grade 2 or 3, AFP ≥ 100 ng/mL, and PT > 13.1 s were independent unfavorable prognostic factors for HCC patients receiving TACE (p < 0.05). Based on these findings, we constructed the ALFP score, which assigns 1 point each for ALBI grade 2 or 3, AFP ≥ 100 ng/mL, and PT > 13.1 s. The score has a range of 0 to 3, and higher scores are associated with poorer outcomes. The median overall survival (OS) varied significantly among different ALFP score groups, both in the training set and the validation set (p < 0.001). We further examined the ALFP score in subgroups based on tumor diameter and the number of intrahepatic lesions. In each subgroup, higher ALFP scores were consistently associated with lower OS (p < 0.05).
UNASSIGNED: Our study confirms the prognostic value of the ALFP score in predicting the survival of HCC patients undergoing TACE. The score incorporates easily obtainable baseline parameters and provides a simple and practical tool for risk stratification and treatment decision-making in HCC patients.

Immuno-mass spectrometry (MS) is a powerful method for the quantitative analysis of low-abundance proteins in biological specimens. In these procedures, collecting specifically and efficiently the target protein antigens from the antigen-antibody complex generated on the surface of nanocarrier beads is crucial and can be performed by hydrolyzing the proteins directly on the beads or after elution. Herein, we optimized the conditions of the immunoaffinity purification via elution using serum α-fetoprotein (AFP) as a model and its specific antibody immobilized covalently on magnetic beads. Antibody-coated beads were incubated with human serum spiked with standard AFP for antigen-antibody reaction. AFP was then eluted from the beads using various eluents, including organic solvents, to optimize the elution conditions. After proteolytically hydrolyzing the eluted protein, stable isotope-labeled standard peptides were added to the hydrolysate to quantify the eluted AFP via liquid chromatography-tandem MS. Using an optimized workflow for quantitative analysis afforded a correlation between the amount of spiked AFP and heavy to light ratios calculated based on peptide ion peak areas, from which an endogenous AFP concentration of 2.3±0.6 ng/mL was determined in normal serum; this is consistent with previous reports using radioimmunoassay methods. The present immuno-MS workflow could apply to the detection and quantitation of other low-abundance biofluid biomarkers.

A vaginal yolk sac tumor (YST) is a rare malignant germ cell tumor for infants and children, and it has been >50 years since the first case was reported. The treatment strategy has changed markedly in the past 50 years, from radical surgical treatment to conservative surgery combined with chemotherapy, and then to combined chemotherapy alone. The present study reports the case of a primary vaginal YST in a 13-month-old girl that was successfully treated by tumor resection combined with chemotherapy. The clinical symptoms, imaging features and treatment characteristics are described in detail, as well as the postoperative treatment. There was no local recurrence or metastasis for the 2 years of follow-up to date. A literature review was also conducted to investigate the clinicopathological features, treatment and prognosis of this tumor. Overall, surgery combined with bleomycin, etoposide and carboplatin combination chemotherapy can be an effective option for vaginal YST.

α-Fetoprotein (AFP) is a kind of fetal protein that is related to tumor, the increasing concentration of which gives birth to a large variety of diseases, such as liver cancer. Therefore, the detection method with super sensitivity, high selectivity, and less time consumption under trace concentrations in early stage of diseases is becoming a necessity. In recent years, nanomaterials have been regarded as significant resources for the exploration of efficient biosensors with high sensitivity, selectivity, speed, as well as simple process, due to their excellent optical, electrical, and chemical properties. In this paper, we reviewed the research progress of AFP biosensors with enhanced sensitivity and selectivity by nanoparticles. Representative examples have also been displayed in this paper to expound the nanotechnologies utilized in the early detection of AFP. Furthermore, challenges of the clinical application of AFP biosensors based on nanotechnology have been elaborated, as well as the development opportunity in this field in the future. This review provides a comprehensive overview on the various nano-biosensor for AFP detection based on functional nanotechnology.

Testicular cancer is believed to originate from disruptions of normal androgen-estrogen balance in-utero. α-fetoprotein (AFP) may modify fetal response to estrogens via estrogen interaction. In a cohort study, we investigated the association between circulating maternal pregnancy AFP and testicular cancer risk in offspring. Of the 56,709 live-born males from a pregnancy screening registry in 1980-1995, our study included 50,519 singleton males with available second trimester blood samples from their mothers and complete covariate ascertainment. Testicular cancer diagnoses and covariate data were obtained from nationwide Danish health registries. Cox regression and Kaplan-Meier analyses estimated the prospective risk of testicular cancer (all, seminoma, nonseminoma) by AFP multiples of the median. During follow-up, 163 (0.3%) of the included males developed testicular cancer, of which 89 (54.6%) were nonseminomas. Maternal serum AFP levels greater than/equal to the median were associated with a relative risk of testicular cancer close to unity (RR 1.04, 95% CI 0.76; 1.41) compared to AFP below the median. Associations differed by type of testicular cancer (RRseminoma 0.81, 95% CI 0.51; 1.29, RRnonseminoma 1.31, 95% CI 0.85; 2.02). On balance, our findings do not support that serum AFP in pregnancy can be used as a predictor of testicular cancer in offspring.

Adenocarcinomas with clear cell morphology may be associated with elevated serum alpha-fetoprotein levels in various organs. We report the case of an alpha-fetoprotein-producing cervical adenocarcinoma with clear cell morphology and compare it immunohistochemically, molecularly, and virologically with cervical clear cell carcinoma, gastric-type mucinous carcinoma, and ovarian clear cell carcinoma. A 51-year-old Japanese woman was initially diagnosed with cervical clear cell carcinoma. The tumor was resistant to standard surgery, radiotherapy, and chemotherapy. Serum carcinoembryonic antigen and alpha-fetoprotein were elevated. The tumor was immunohistochemically positive for alpha-fetoprotein, human chorionic gonadotropin, cytokeratin 20, spalt-like transcription factor 4, glypican 3, MUC6, and HIK1083. Gene panel testing revealed CCNE1 amplification, CDKN2A loss, and TP53 R282W. We compared the present case with 120 ovarian clear cell carcinoma cases using a tissue microarray. Only one case (0.8%) showed very limited immunohistochemical positivity for alpha-fetoprotein. Of the 54 cases in which serum carcinoembryonic antigen was measured, only one (1.9%) was elevated (19.9 ng/mL). We diagnosed the case as alpha-fetoprotein-producing cervical gastric-type mucinous carcinoma with enteroblastic differentiation. In conclusion, alpha-fetoprotein-producing cervical adenocarcinoma is a rare but aggressive tumor. Clinicians and pathologists should be aware of this unfamiliar tumor, its diagnostic clues, prognostic markers, and treatment strategies.