Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Surg Oncol. 2013 Feb;107(2):124-9. doi: 10.1002/jso.23261. Epub 2012 Sep 18.
Signet ring cell carcinoma (SRC) of the stomach is known to have different microscopic and biologic characteristics compared to non-SRC. The pathologic report has documented partly SRC component with main histologies. However, the clinical significance of SRC mixture has not been reported. Aim was to investigate clinicopathologic features of mixed-SRC histology in early gastric cancer (EGC).
Two thousand two hundred eight patients were diagnosed with EGC and underwent surgery. The patients were divided into three groups such as adenocarcinoma with partly SRC (mixed-SRC group), only adenocarcinoma (adenocarcinoma group), and SRC (SRC group). Clinicopathologic characteristics were compared.
The SRC group was more associated with younger age, female, mid-body, mucosa-confined, depressed type, lower lymph node metastasis (LNM), lower lymphovascular invasion, and better survival rate than adenocarcinoma group. The mixed-SRC group was more associated with younger age, female, upper-body, and depressed type than adenocarcinoma group, similar to SRC group. However, the mixed-SRC group showed more submucosal invasion, larger size, and higher LNM than other groups. The mixed-SRC component was one of the independent risk factors of LNM.
Mixed-SRC histology in EGC showed more aggressive behavior than other histologies. Clinical considerations of mixed-SRC histology may be helpful to decide on a specific cancer treatment.
与非印戒细胞癌（SRC）相比，胃印戒细胞癌（SRC）具有不同的微观和生物学特征。病理报告记录了部分 SRC 成分和主要组织学。然而，SRC 混合的临床意义尚未报道。目的是研究早期胃癌（EGC）中混合 SRC 组织学的临床病理特征。
对 2208 例诊断为 EGC 并接受手术的患者进行了研究。患者分为三组：腺鳞癌伴部分 SRC（混合 SRC 组）、仅腺癌（腺癌组）和 SRC（SRC 组）。比较了临床病理特征。
SRC 组的年龄、性别、肿瘤位置、肿瘤类型、肿瘤浸润深度、淋巴结转移（LNM）、脉管侵犯和生存率均优于腺癌组。混合 SRC 组的年龄、性别、肿瘤位置、肿瘤类型与 SRC 组相似，均优于腺癌组。然而，混合 SRC 组的黏膜下浸润、肿瘤大小和 LNM 均高于其他组。混合 SRC 成分是 LNM 的独立危险因素之一。
EGC 中的混合 SRC 组织学表现出比其他组织学更具侵袭性的行为。考虑混合 SRC 组织学可能有助于决定特定的癌症治疗。
