Department of Gastroenterologic Surgery, Affiliated Tumor Hospital of Harbin Medical University, 6 Baojian Road, Harbin 150040, China.
J Gastrointest Surg. 2010 Apr;14(4):601-6. doi: 10.1007/s11605-009-1127-9. Epub 2009 Dec 22.
Reports of clinicopathological features and prognosis in patients with signet ring cell carcinoma of the stomach (SRC) are conflicting. The aim was to describe the clinicopathological features and prognosis of patients with SRC in comparison with non-signet ring cell carcinoma of the stomach (NSRC).
In this retrospective study, we reviewed the records of 1,439 consecutive patients diagnosed with gastric carcinoma who were resected surgically from 1993 to 2003. Among them, 218 patients (15.1%) with SRC were compared with 1,221 patients with NSRC.
There were significant differences in tumor size, tumor location, macroscopic type, depth on invasion, lymph node metastasis, lymphatic invasion, tumor stage, chemotherapy, and curability between the patients with SRC histology and NSRC. The overall 5-year survival of patients with SRC was 44.9% as compared with 36.0% for patients with NSRC (P = 0.013). Multivariate analysis showed that lymph node metastasis and curative resection were significant factors affecting survival. A significant survival benefit for curative resection was observed, with a 5-year survival rate of 58.5% compared with non-curatively resected cases (8.4%).
When stage matched, SRC patients had a similar survival to NSRC patients. Curative resection is recommended to improve the prognosis of patients with SRC.
关于胃的印戒细胞癌(SRC)患者的临床病理特征和预后的报告结果不一。本研究旨在描述 SRC 患者的临床病理特征,并与非印戒细胞癌(NSRC)患者的临床病理特征和预后进行比较。
在这项回顾性研究中,我们对 1993 年至 2003 年间连续接受手术切除的 1439 例胃癌患者的记录进行了回顾。其中,218 例 SRC 患者与 1221 例 NSRC 患者进行了比较。
SRC 组织学患者与 NSRC 患者在肿瘤大小、肿瘤位置、大体类型、浸润深度、淋巴结转移、淋巴管浸润、肿瘤分期、化疗和可治愈性方面存在显著差异。SRC 患者的总 5 年生存率为 44.9%,而 NSRC 患者为 36.0%(P = 0.013)。多因素分析显示,淋巴结转移和根治性切除是影响生存的重要因素。根治性切除有显著的生存获益,5 年生存率为 58.5%,而非根治性切除的 5 年生存率为 8.4%。
在分期匹配的情况下,SRC 患者的生存情况与 NSRC 患者相似。建议进行根治性切除以改善 SRC 患者的预后。