Abstract
Background: Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients.Methods: From 2003 to 2017, surgically resected primary GC patients were retrospectively reviewed. All enrolled patients were divided into three groups according to the proportion of SRC. The overall survival (OS) and disease-free survival (DFS) of GC patients with different tumor stages were analyzed.Results: Patients with SRC or mixed-SRC were more associated with female, younger age, middle or lower third of the stomach, larger tumor, higher pN stage, and more lymphovascular invasion. For GC patients in stage I, multivariate survival analysis showed that age >60, SRC components >50%, and pT stage were independent prognostic factors for OS (all p < 0.05). The 5-year OS of patients with SRC were higher than that of patients with pure adenocarcinoma (p = 0.021). For GC patients in stage II/III, multivariate survival analysis showed that age >60, SRC proportion, surgical types, Borrmann's type, pT stage, pN stage, and lymphovascular invasion were independent prognostic factors for OS (all p < 0.05). The 5-year OS/DFS of patients with SRC were lower than that of patients with pure adenocarcinoma (p < 0.001).Conclusions: SRC seemed to be a favorable prognostic factor in GC patients in stage I. However, for GC patients in stage II/III, the SRC components were associated with poor prognosis, independent of other clinicopathological factors.
Highlights
Gastric carcinoma (GC) contains a group of histopathological heterogeneous components, such as adenocarcinoma, signet ring cell (SRC) carcinoma, neuroendocrine carcinoma, squamous cell carcinoma, etc
According to the proportion of SRC components (0, 1–50, or >50%), all cases were categorized into three groups: [1] 3,479 pure adenocarcinoma cases, [2] 406 adenocarcinomas cases mixed with SRC (SRC component 1–50%), and [3] 254 SRC cases (SRC component >50%)
The World Health Organization (WHO) pathological diagnostic standards define SRC as the pathologic component of more than 50% of the whole tumor, patients of gastric adenocarcinoma mixed with SRC of
Summary
Gastric carcinoma (GC) contains a group of histopathological heterogeneous components, such as adenocarcinoma, signet ring cell (SRC) carcinoma, neuroendocrine carcinoma, squamous cell carcinoma, etc. In GC, adenocarcinoma is the most common pathological type, which accounts for about 90% of all GC cases [1]. The SRC carcinoma only account for only about 5–10% of all GC cases [2]. The 2010 World Health Organization (WHO) pathological classification defines SRC based on the proportion of the main components (>50%) [4]. Gastric adenocarcinoma mixed with SRC components (mixedSRC) are frequently observed in the clinic, which refers to a mixture of adenocarcinoma and SRC components of 50% or less. Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients
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