Abstract

Signet ring cell carcinoma (SRC) of the stomach is a histological type based on microscopic characteristics. SRC's clinicopathological characteristics and prognosis are still controversial. Our study is to describe the clinicopathological features and multidetector computed tomography (MDCT) findings of patients with SRC of the stomach in comparison with nonsignet ring cell adenocarcinoma (NSRC). We retrospectively analyzed data from 241 patients who had undergone curative gastrectomy, including 62 SRC and 179 NSRC. Clinicopathological outcomes and MDCT findings were evaluated, and we investigated whether these variables were correlated with histopathological type. In early gastric carcinoma, patients with SRC were younger (50.2 vs. 60.2 years; P = 0.000) and more likely to be observed in the middle and lower third stomach (P = 0.010). Early SRC had a tendency to be confined to the mucosa (82.1%). There were significant differences in degree of enhancement between early SRC and NSRC on MDCT imaging (P < 0.001). In advanced gastric carcinoma, SRC was more likely to be stage T3‐4 (100%). SRC patients had thicker tumors (P = 0.001) and a higher frequency of diffusely infiltrative gross appearance (P < 0.001). SRC was more likely to have high‐degree contrast enhancement than were NSRC (P = 0.001). The maximal diameter of SRC tumor on MDCT imaging correlated with lymph node metastasis (sensitivity 93.9%, specificity 74.1%) and serosal invasion (sensitivity 89.5%, specificity 78.0%) of SRC. In conclusion, SRC differs significantly from NSRC in clinicopathological features at presentation. MDCT could help differentiate advanced gastric SRC from NSRC based on the thickened stomach wall, high‐degree contrast enhancement, and a higher frequency of diffusely infiltrative gross appearance, particularly in combination.

Highlights

  • Gastric cancer represents the second leading cause of cancer death and is the second most common invasive cancer in China

  • The clinicopathological characteristics of early signet ring cell cancer (SRC) were compared with those of nonsignet ring cell adenocarcinoma (NSRC), and significant differences were observed with respect to age, tumor location, and depth of tumor invasion

  • SRC is a subtype of gastric carcinoma that is distinct from other gastric adenocarcinomas at presentation

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Summary

Introduction

The incidence of gastric cancer has declined in the last several decades, there is evidence of an increasing incidence of signet ring cell cancer (SRC) subtypes, comprising 11–37% of all gastric cancers in recent years [3–5]. This increase in the proportion of SRC in cases of gastric adenocarcinoma can be explained by changes in the pathological classifications used to characterize these cancers [6]. SRC carcinoma of the stomach is a histological type with controversial clinical outcomes, depending on whether it is early or advanced. It is clinically useful to be able to distinguish between SRC and NSRC in patients who have this cancer

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