Department of Biliary Tract Surgery, General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Biosci Trends. 2024 Sep 16;18(4):379-387. doi: 10.5582/bst.2024.01230. Epub 2024 Aug 25.
The prognostic significance of the signet-ring cell component in gallbladder carcinoma (GBC) has not been systematically evaluated. The aim of this study was to assess the similarities and differences between gallbladder signet-ring cell carcinoma (GBSRCA) and gallbladder adenocarcinoma (GBAC) in terms of clinicopathological features and long-term survival. Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed 6,612 patients diagnosed with gallbladder cancer between 2000 and 2021. The cohort included 147 patients with GBSRCA and 6,465 with GBAC. Patients with GBSRCA were significantly younger, with 33.3% being age 60 or younger compared to 23.9% of patients with GBAC (p = 0.009). There was a higher proportion of females in the GBSRCA group (77.6%) compared to the GBAC group (70.1%, p = 0.049). GBSRCA was associated with a more advanced tumor stage (T3-T4: 56.5% vs. 44.4%, P = 0.004), higher rates of lymph node metastasis (43.5% vs. 28.0%, P < 0.001), and poorer differentiation status (poorly to undifferentiated: 80.3% vs. 29.7%, P < 0.001). Survival analysis revealed that patients with GBSRCA had significantly worse overall survival (OS) and cancer-specific survival (CSS) compared to patients with GBAC (p < 0.001). GBSRCA was an independent prognostic factor for OS (P = 0.001) in the entire cohort, while the T stage and N stage were independent prognostic factors for OS and CSS in patients with GBSRCA. Even after propensity score matching, patients with GBSRCA still had a poorer prognosis.
胆囊癌（GBC）中印戒细胞成分的预后意义尚未得到系统评估。本研究旨在评估胆囊印戒细胞癌（GBSRCA）和胆囊腺癌（GBAC）在临床病理特征和长期生存方面的异同。我们使用监测、流行病学和最终结果（SEER）数据库分析了 2000 年至 2021 年间诊断为胆囊癌的 6612 例患者。该队列包括 147 例 GBSRCA 患者和 6465 例 GBAC 患者。GBSRCA 患者明显更年轻，33.3%的患者年龄在 60 岁或以下，而 GBAC 患者为 23.9%（p=0.009）。GBSRCA 组女性比例较高（77.6%），而 GBAC 组为 70.1%（p=0.049）。GBSRCA 与更晚期的肿瘤分期（T3-T4：56.5%比 44.4%，P=0.004）、更高的淋巴结转移率（43.5%比 28.0%，P<0.001）和较差的分化状态（低分化或未分化：80.3%比 29.7%，P<0.001）相关。生存分析显示，GBSRCA 患者的总生存（OS）和癌症特异性生存（CSS）明显差于 GBAC 患者（p<0.001）。GBSRCA 是整个队列中 OS 的独立预后因素（P=0.001），而 T 分期和 N 分期是 GBSRCA 患者 OS 和 CSS 的独立预后因素。即使在倾向评分匹配后，GBSRCA 患者的预后仍较差。
