Abstract
Colorectal signet ring cell adenocarcinoma (SRA) is a rare entity that accounts for 1% of colorectal carcinoma (CRC). SRA has specific clinicopathological features different from ordinary adenocarcinoma (OA) and colloid carcinoma (CC). In this study, we aimed to compare SRA, OA and CC regarding clinicopathological, histological parameters, survival, EGFR, MMP-13 and E-cadherin expressions. We studied tumor tissue specimens from 19 patients with SRA, 47 patients with OA and 56 patients with CC. High density manual tissue microarrays were constructed. SRA was significantly associated with younger age, more lymph node metastasis, advanced stage, more lymphovascular emboli, perineural invasion and worse disease-free and overall survival. OA was significantly associated with more peritumoral lymphocytic infiltrate and microscopic abscess formation than SRA. SRA expressed EGFR, MMP-13 and E-cadherin in significantly lower rates than OA. The same was true for CC but with no significant difference of MMP-13 expression with SRA. Neither EGFR, MMP-13 nor E-cadherin expression showed a significant impact on disease-free or overall survival in patients with SRA. Our results support that targeted therapies against EGFR, MMP-13 and E-cadherin are not expected to be useful in patients with SRA. Further molecular studies are needed to introduce tailored targeted therapies for SRA.
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