Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach
Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach
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DOI：
10.1007/s10120-013-0234-1
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发表时间：
2014-01-01
期刊：
影响因子：
7.4
通讯作者：
Jung, Sung-Ae
中科院分区：
文献类型：
--
作者：
Kwon, Kyoung-Joo;Shim, Ki-Nam;Jung, Sung-Ae
胃印戒细胞癌（SRC）是一种基于微观特征的组织学类型。尽管SRC具有独特的临床病理特征，但结果不一致，生存结果不确定。我们回顾性研究了1999年至2009年在我院接受胃切除术的769例胃癌患者。其中，326例患者（42.4%）为早期胃癌（EGC），443例患者（57.6%）为晚期胃癌（AGC）。比较SRC、分化型和未分化型胃癌患者的性别、年龄、肿瘤部位、肉眼类型、肿瘤大小、镜下侵犯和生存率。51例患者（15.6%）在EGC中出现SRC； SRC与分化型组织学类型在性别、年龄、部位、肉眼类型、大小等方面存在显着差异。然而，除了肉眼可见的类型外，SRC与未分化型胃癌没有差异。 57 名患者 (12.9%) 在 AGC 中出现 SRC。 SRC与分化型组织学类型之间的性别、年龄、部位、大小、宏观类型、神经周围侵犯、N分期和肝转移有显着差异。未分化型胃癌在性别、肉眼类型和肝转移方面存在差异。 SRC 和其他细胞类型的总体存活率存在差异 (P < 0.001)。在所有研究患者中，年龄[风险比（HR）1.013，P = 0.041]和肿瘤、淋巴结和转移（TNM）分期（HR 2.350，P < 0.001）是预测生存的重要因素。排除姑息性切除或转移的患者，TNM分期仍然是生存的重要因素（HR 2.077，P < 0.001）。SRC患者表现出相似的临床病理特征，且组织学未分化。 SRC患者的生存反映了未分化胃癌患者更好的预后。然而，当将患者范围缩小到仅患有 EGC 的患者时，EGC 患者的生存率在组织学类型之间没有表现出差异。在AGC患者中，SRC患者的预后比其他细胞类型更差。
Signet ring cell carcinoma (SRC) of the stomach is a histological type based on microscopic characteristics. Although the distinctive clinicopathological features of SRC have been reported, results are inconsistent and survival outcomes are uncertain.We retrospectively studied 769 patients with gastric carcinoma who underwent gastrectomy in our institute from 1999 to 2009. Among them, 326 patients (42.4 %) had early gastric cancer (EGC) and 443 patients (57.6 %) had advanced gastric cancer (AGC). Sex, age, tumor location, macroscopic type, tumor size, microscopic invasion, and survival rate were compared between patients with SRC, differentiated-, and undifferentiated-type gastric carcinomas.Fifty-one patients (15.6 %) had SRC in EGC; there were significant differences in sex, age, location, macroscopic type, and size between SRC and the differentiated histological type. However, there was no difference between SRC and undifferentiated-type gastric carcinoma, except for the macroscopic type. Fifty-seven patients (12.9 %) had SRC in AGC. Sex, age, location, size, macroscopic type, perineural invasion, N stage, and hepatic metastasis were significantly different between SRC and the differentiated histological type. Undifferentiated-type gastric carcinoma differed in sex, macroscopic type, and hepatic metastasis. The overall survival rate differed between SRC and other cell types (P < 0.001). Among all the study patients, age [hazard ratio (HR) 1.013, P = 0.041] and tumor, node, and metastasis (TNM) stage (HR 2.350, P < 0.001) were important factors for predicting survival. Omitting patients with palliative resection or metastases, TNM stage was still an important factor for survival (HR 2.077, P < 0.001).Patients with SRC showed similar clinicopathological features with undifferentiated histology. The survival of patients with SRC reflected a better prognosis in patients with undifferentiated gastric carcinoma. However, when narrowing the patients to those with EGC only, survival in EGC patients exhibited no difference between histological types. Among AGC patients, SRC patients had a worse prognosis than other cell types.