Dong Xiaoyuan, Sun Guorui, Qu Hui, He Qingsi, Hao Zhaofan
Department of Hematology, Qilu Hospital of Shandong University, Jinan, China.
Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
Front Surg. 2021 Jul 15;8:642468. doi: 10.3389/fsurg.2021.642468. eCollection 2021.
Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients. From 2003 to 2017, surgically resected primary GC patients were retrospectively reviewed. All enrolled patients were divided into three groups according to the proportion of SRC. The overall survival (OS) and disease-free survival (DFS) of GC patients with different tumor stages were analyzed. Patients with SRC or mixed-SRC were more associated with female, younger age, middle or lower third of the stomach, larger tumor, higher pN stage, and more lymphovascular invasion. For GC patients in stage I, multivariate survival analysis showed that age >60, SRC components >50%, and pT stage were independent prognostic factors for OS (all < 0.05). The 5-year OS of patients with SRC were higher than that of patients with pure adenocarcinoma ( = 0.021). For GC patients in stage II/III, multivariate survival analysis showed that age >60, SRC proportion, surgical types, Borrmann's type, pT stage, pN stage, and lymphovascular invasion were independent prognostic factors for OS (all < 0.05). The 5-year OS/DFS of patients with SRC were lower than that of patients with pure adenocarcinoma ( < 0.001). SRC seemed to be a favorable prognostic factor in GC patients in stage I. However, for GC patients in stage II/III, the SRC components were associated with poor prognosis, independent of other clinicopathological factors.
胃癌（GC）中含有印戒细胞（SRC）成分在术后病理评估中经常可见。本研究旨在探讨SRC成分在GC患者中的预后意义。回顾性分析了2003年至2017年接受手术切除的原发性GC患者。所有纳入患者根据SRC比例分为三组。分析了不同肿瘤分期的GC患者的总生存期（OS）和无病生存期（DFS）。SRC或混合SRC患者与女性、年龄较轻、胃中下部、肿瘤较大、pN分期较高以及更多的淋巴管侵犯更相关。对于I期GC患者，多因素生存分析显示年龄>60岁、SRC成分>50%和pT分期是OS的独立预后因素（均P<0.05）。SRC患者的5年OS高于纯腺癌患者（P = 0.021）。对于II/III期GC患者，多因素生存分析显示年龄>60岁、SRC比例、手术方式、Borrmann分型、pT分期、pN分期和淋巴管侵犯是OS的独立预后因素（均P<0.05）。SRC患者的5年OS/DFS低于纯腺癌患者（P<0.001）。SRC似乎是I期GC患者的一个有利预后因素。然而，对于II/III期GC患者，SRC成分与不良预后相关，独立于其他临床病理因素。
