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目的 探讨血清甲胎蛋白(AFP)在胃癌患者中的阳性率及其与临床病理特征和患者预后的相关性.方法 回顾性分析2014年1月—2017年1月在江南大学附属医院住院的1,494例胃癌患者的病历资料,其中AFP阳性胃癌(alpha-fetoprotein positive gastric cancer,AFPGC)76例.详细记录AFPGC患者的临床病理及随访资料,采用SPSS 16.0统计软件分析AFPGC的临床病理特征及影响患者预后的因素.结果 AFPGC占同期住院胃癌患者的5.1％,中位OS为14个月,1年总生存率为68.6％,2年总生存率52.7％,3年总生存率为49％.淋巴结转移率为78.9％,远处转移率为47.4％,其中肝转移为27.6％,手术组中位OS为17个月,非手术组中位OS为8个月,两组之间生存差异有统计学意义(P<0.001),COX多因素回归分析证实,手术与否是影响AFPGC患者预后的独立因素(P=0.008,HR=0.275,95％CI:0.107～0.711).结论 AFPGC具有易发生远处转移及淋巴结转移的特点,且预后差,早诊断、早期手术治疗是目前提高治愈率和患者生存率的重要治疗手段.“,”Objective To investigate the positive rate of serum AFP in patients with gastric cancer and its correlation with clinicopathological features and prognosis in patient with gastric cancer. Methods A total of 1,494 patients with gastric cancer were enrolled in this study from January 2014 to January 2017 in the Affiliated Hospital of Jiangnan University, including 76 cases of alpha-fetoprotein positive gastric cancer (AFPGC). The clinical and pathological characteristics of AFPGC and the prognostic factors of AFPGC were analyzed by SPSS 16.0 statistical software. Results AFPGC accounted for 5.1％ of patients with gastric cancer in the same period, the median OS was 14 months, the 1-year overall survival rate was 68.6％, the 2-year overall survival rate was 52.7％, and the 3-year overall survival rate was 49％. Lymph node metastasis rate was 78.9％, distant metastasis rate was 47.4％, of which the liver metastasis was 27.6％. The median OS was 17 months in the operation group and 8 months in the nonoperatively group (P=0.008, HR=0.275, 95％CI: 0.107～0.711), and the effect of surgery on the prognosis of AFPGC patients was significantly higher than that of the control group (P<0.05). Conclusion AFPGC is characterized by distant metastasis and lymph node metastasis, and poor prognosis, early diagnosis and early surgical treatment are the important therapeutic methods to improve the cure rate and survival rate.