Nie Run-Cong, Yuan Shu-Qiang, Li Yuan-Fang, Chen Yong-Ming, Chen Xiao-Jiang, Zhu Bao-Yan, Xu Li-Pu, Zhou Zhi-Wei, Chen Shi, Chen Ying-Bo
Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Gastric Surgery, The 6th Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
J Cancer. 2017 Sep 20;8(17):3396-3404. doi: 10.7150/jca.21017. eCollection 2017.
Previous studies of the prognostic value of the signet ring cell (SRC) type have yielded inconsistent results. Therefore, the aim of the present meta-analysis is to explore the clinicopathological characteristics and prognostic value of SRCs. Relevant articles that compared SRC and non-SRC type in PubMed and Web of Science were comprehensively searched. Then, a meta-analysis was performed. A total of 19 studies including 35947 cases were analyzed. Compared with non-SRC patients, SRC patients tended to be younger (WMD: -3.88, P=0.001) and predominantly female (OR: 1.60, P<0.001). Additionally, SRC patients exhibited less upper third tumor location (OR: 0.62, P<0.001) and less frequent hematogenous metastasis (OR: 0.41, P<0.001). There was no difference in overall survival (OS) between SRC and non-SRC patients in the total population (HR: 1.02, P=0.830). Early gastric cancer with SRCs was associated with better OS (HR: 0.57, P=0.002), while advanced gastric cancer with non-SRCs was associated with a worse prognosis (HR: 1.17, P<0.001). This meta-analysis revealed that SRC tends to affect young females and tends to be located in the middle and lower third of the stomach. Early SRCs are associated with better prognoses, while advanced SRCs are associated with worse prognoses.
以往关于印戒细胞(SRC)型预后价值的研究结果并不一致。因此,本荟萃分析的目的是探讨SRC的临床病理特征和预后价值。我们全面检索了PubMed和Web of Science中比较SRC型和非SRC型的相关文章。然后,进行了荟萃分析。共分析了19项研究,包括35947例病例。与非SRC患者相比,SRC患者往往更年轻(加权均数差:-3.88,P = 0.001),且以女性为主(比值比:1.60,P < 0.001)。此外,SRC患者肿瘤位于胃上三分之一的比例较低(比值比:0.62,P < 0.001),血行转移的频率也较低(比值比:0.41,P < 0.001)。在总体人群中,SRC患者和非SRC患者的总生存期(OS)没有差异(风险比:1.02,P = 0.830)。早期胃癌伴SRC与较好的OS相关(风险比:0.57,P = 0.002),而晚期胃癌伴非SRC则预后较差(风险比:1.17,P < 0.001)。这项荟萃分析表明,SRC倾向于影响年轻女性,且倾向于位于胃的中下部三分之一。早期SRC预后较好,而晚期SRC预后较差。