Kazi Mufaddal, Patel Harshit, Choudhary Nazia, Jain Agrim, Dudhat Shruti, Naik Sakshi, Desouza Ashwin, Saklani Avanish
Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Department of Surgical Oncology, Homi Bhabha National Institute, Mumbai, India.
Saudi J Med Med Sci. 2024 Jan-Mar;12(1):71-75. doi: 10.4103/sjmms.sjmms_260_23. Epub 2024 Jan 15.
Signet-ring cell colorectal carcinoma (SRCC) is an extremely aggressive yet uncommon histologic subtype of colorectal cancer (CRC) with an unknown etiology. There is a stark difference in the prevalence of signet cancers between Western countries and the Indian subcontinent; however, India itself is a vast and diverse country with variable cancer incidence.
To study the spatial epidemiology of SRCC in India for identifying regions with high prevalence.
This retrospective study included all patients diagnosed with colorectal adenocarcinoma at Tata Memorial Hospital, the largest colorectal cancer referral unit in India, between January 2020 and December 2022. Geocoding based on the location of the residence was done to map the incidences. Comparisons were performed between the proportion of signet cell and non-signet colorectal cancers.
A total of 4100 patients with colon or rectal adenocarcinomas were included, of which signet cell histology was found in 624 (15%) patients. SRCC accounted for the highest proportions of CRCs in the Central (19%) and Northern (19%) regions, and the lowest in the North-Eastern (10%) and Western (12%) regions of India ( < 0.001), with non-overlapping confidence intervals. Compared with patients with non-signet CRCs, those with SRCC more commonly had colon cancers (22% vs. 17%; = 0.003) and belonged to a lower socioeconomic background (67% vs. 59%; < 0.001).
This study found that SRCCs accounted for a significant proportion of CRC cases in India, but there was no substantial disparity in distribution across regions.
印戒细胞型结直肠癌（SRCC）是结直肠癌（CRC）中一种极具侵袭性但并不常见的组织学亚型，其病因不明。西方国家和印度次大陆的印戒细胞癌患病率存在显著差异；然而，印度本身是一个幅员辽阔且多样化的国家，癌症发病率各不相同。
研究印度SRCC的空间流行病学，以确定患病率高的地区。
这项回顾性研究纳入了2020年1月至2022年12月期间在印度最大的结直肠癌转诊单位塔塔纪念医院被诊断为结直肠腺癌的所有患者。根据居住地位置进行地理编码以绘制发病率地图。对印戒细胞型和非印戒细胞型结直肠癌的比例进行了比较。
共纳入4100例结肠或直肠腺癌患者，其中624例（15%）患者为印戒细胞组织学类型。SRCC在印度中部（19%）和北部（19%）地区的结直肠癌中占比最高，在东北部（10%）和西部（12%）地区占比最低（<0.001），置信区间不重叠。与非印戒细胞型CRC患者相比，SRCC患者更常见结肠癌（22%对17%；=0.003），且社会经济背景较低（67%对59%；<0.001）。
本研究发现，SRCC在印度的CRC病例中占相当大比例，但各地区分布没有实质性差异。
