AFP elevation

We report six cases of locally advanced, non-metastatic gastric cancer with elevated AFP, all of which demonstrated a favorable response and were well tolerated by the patients after the use of immune checkpoint inhibitors and neoadjuvant chemotherapy. This study suggests that programmed death receptor 1(PD-1) checkpoint inhibitors plus chemotherapy can benefit patients with AFPGC and provide a reference for the treatment of patients with AFPGC, and its mechanism of action deserves further study.

First-line conversion therapy with oxaliplatin, fluoropyrimidine, sintilimab (a programmed death-1 inhibitor), and later trastuzumab yielded only transient stabilization followed by clear progression: After six cycles, AFP rose to 1 546.07 μg/L and target lymph nodes enlarged to 46 mm×31 mm on CT. Given treatment failure and persistent HER2 positivity, a second-line, biology-informed regimen was initiated: Disitamab vedotin (an HER2-targeted antibody-drug conjugate delivering monomethyl auristatin E), lenvatinib (a multi-targeted tyrosine kinase inhibitor blocking vascular endothelial growth factor receptor and other pro-angiogenic pathways), tislelizumab (a programmed death-1 inhibitor), and short-course capecitabine (discontinued after 7 days due to grade 3 thrombocytopenia)...This case underscores that in HER2-positive, chemotherapy-refractory HAS, a rationally designed, multimodal regimen integrating an HER2-directed antibody-drug conjugate, antiangiogenic agent, and immune checkpoint blockade can overcome therapeutic resistance, achieve meaningful downstaging, and enable long-term disease control. Early molecular characterization and aggressive, persona-lized intervention are essential for improving outcomes in this rare malignancy.

Individualized and multimodal therapeutic approaches are fundamental to improving clinical outcomes due to the high degree of heterogeneity in AFPGC. Therefore, a comprehensive evaluation of serum AFP levels, radiological findings, and pathological characteristics is essential for the development of personalized treatment regimens.

Treatment involved a multimodal strategy combining transarterial chemoembolization (TACE), fractionated radiotherapy, and combination immunotherapy with camrelizumab plus apatinib. This case highlights the rare entity of direct renal invasion from HCC and provides practical insights into its diagnosis and comprehensive management. It illustrates the clinical feasibility and potential benefit of a combined locoregional and systemic strategy in advanced HCC with such uncommon extrahepatic renal involvement, underscoring the importance of individualized treatment in these complex presentations.

Current evidence suggests that AFP identifies biologically aggressive subsets of GEP-NENs, reflecting disease burden in specific contexts. While AFP should not be considered an independent biomarker, it holds potential as a contextual signal of aggressive tumor biology and as an adjunctive tool within integrated clinical and pathological frameworks.

Hepatic metastasis of ONB can closely mimic primary liver cancer on imaging, underscoring the necessity of integrating comprehensive clinical history, imaging assessment, and pathological confirmation to avoid misdiagnosis.

Multivariate analysis identified four independent predictors: elevated alpha-fetoprotein (AFP ≥ 467 ng/mL) (OR = 8.5, 95% CI: 4.2-17.30; p < 0.001), presence of non-enhancing necrotic areas (OR = 5.92, 95% CI: 1.82-19.30, p = 0.003), intratumoral arteries (OR = 6.61, 95% CI: 2.28-19.22, p < 0.001), and peritumoral feeding arteries (OR = 3.13, 95% CI: 1.15-8.50, p = 0.025). An integrated prediction model that combines ultrasound imaging and clinical parameters offers a feasible, non-invasive approach for accurate preoperative identification of MTM-HCC.

This review outlined the multidimensional diagnostic hurdles in HAS and underscored the necessity of an integrated, multidisciplinary approach. Enhanced tissue sampling, combined immunohistochemical panels, and emerging molecular tools may collectively improve diagnostic accuracy and clinical outcomes for this aggressive gastric malignancy.

This study indicates that TA and SR offer similar therapeutic outcomes in early-stage HCC, with comparable survival outcomes for patients.

This case report details the presentation of a 30-year-old female patient with gastric adenocarcinoma that metastasized to the ovaries, characterized by a significant elevation in serum AFP levels. This case highlights the critical need to consider uncommon metastatic patterns and unusual tumor marker elevations during the comprehensive evaluation and management of gastric cancer patients.

Postoperatively, AFP normalized, and the patient has remained recurrence-free. This case highlights the potential role of desperation surgery in achieving long-term survival in selected patients with PMNSGCT, despite increased levels of tumor markers.

HMGA1 serves as a robust prognostic biomarker and functional driver of malignant progression in LIHC. Its integration into prognostic models may enhance risk stratification and guide personalized therapeutic strategies. Nevertheless, further in-vivo validation and prospective clinical studies are required to establish its translational applicability.