Early gastric carcinoma with signet ring cell histology
Early gastric carcinoma with signet ring cell histology
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作者：
Hyung, WJ;Noh, SH;Min, JS
背景早期胃印戒细胞癌（SRC）的生物学行为及预后一直存在争议。为阐明早期胃癌的生物学行为，比较早期胃癌与其他组织学类型的临床病理特征及预后。方法：回顾性分析1987 ~ 1995年行胃切除术的933例早期胃癌患者的临床资料。其中，263例SRC患者与670例其他组织学类型的患者进行了比较。年轻患者更经常有SRC比非SRC。此外，SRC中的女性比例高于非SRC。印戒细胞癌有较大比例的粘膜局限性病变和较低的淋巴结转移率比非SRC。即使在对临床病理特征进行分层后，SRC的淋巴结转移率仍低于非SRC。当比较SRC和非SRC的未分化组织学之间的淋巴结转移率时，SRC表现出较低的淋巴结转移率。多因素分析显示，SRC组织学类型是早期胃癌淋巴结转移的独立危险因素。SRC患者的预后明显好于非SRC患者（P = 0.0104）。早期胃癌伴发SRC是一种独特的胃癌类型，其临床病理特征和预后均不相同。早期胃癌伴SRC患者预后良好，淋巴结转移率低，可考虑行微创手术治疗，提高患者生活质量。(C)2002年美国癌症协会。
BACKGROUND. There has been much controversy surrounding the biologic behavior and prognosis Of early stage gastric signet ring cell carcinoma (SRC). To clarify the biologic behavior of early stage gastric SRC (early SRC), we compared the clinicopathologic features and prognosis of early SRC with other histologic type,.METHODS, A total of 933 patients with early gastric carcinoma who had undergone gastrectomy from 1987 to 1995 were retrospectively analysed. Among them, 263 patients with SRC were compared to 670 patients with other histologic types.RESULTS. Younger patients more Often had SRC than non-SRC. Additionally, the proportion of females was greater in SRC than in non-SRC. Signet ring cell carcinoma had a larger proportion of mucosa-confined lesions and a lower rate of lymph node metastasis than non-SRC. Even after Stratifying the clinicopathologic characteristics, SRC Showed a lower rate of lymph node metastasis than non-SRC. When the lymph node metastasis rate was compared between SRC and undifferentiated histology other than SRC, SRC demonstrated a lower lymph node metastasis rate. Multivariate analysis showed that SRC histology was a negative independent risk factor for lymph node metastasis in early gastric carcinoma. The prognosis of SRC was significantly better than that of non-SRC (P = 0.0104).CONCLUSIONS. Early gastric carcinoma with SRC is a distinct type of gastric carcinoma in terms of clinicopathologic features and prognosis. The favorable prognosis and lower rate of lymph node metastasis in early SRC suggest that the patients with early gastric carcinoma With SRC could be candidates fur less invasive surgeries for all improved quality of life. (C) 2002 American Cancer Society.