Sui Wannian, Chen Peifeng, Chen Zhangming, Han Wenxiu
Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, China.
Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, China.
Eur J Surg Oncol. 2025 Aug;51(8):110012. doi: 10.1016/j.ejso.2025.110012. Epub 2025 Apr 2.
Signet ring cell (SRC) carcinoma significantly impacts the prognosis of gastric cancer (GC) patients, yet the influence of SRC proportion is often overlooked. This study aims to clarify the relationship between SRC proportion and prognosis and to construct a prognostic prediction model for gastric cancer patients with SRC components (GSRCC).
Clinical data from 628 GSRCC patients who underwent gastrectomy at the First Affiliated Hospital of Anhui Medical University from November 2011 to December 2018 were collected. Patients were randomly divided into a training set (442 patients) and a validation set (186 patients). Prognostic risk factors were identified in the training set, and a nomogram prediction model was established. The internal and external validation were conducted on the training and validation sets.
The SRC proportion (hazard ratio [HR]: 9.569, P < 0.001), depth of invasion (HR: 6.838, P = 0.001), tumor size (HR: 1.573, P = 0.044), and N stage (HR: 6.511, P < 0.001) were independent prognostic factors for GSRCC. The nomogram showed excellent performance in predicting 1-year, 3-year, and 5-year overall survival (OS) with AUC values of 0.819, 0.832, and 0.874 in the training set, and of 0.815, 0.847, and 0.876 in the validation set, respectively. Calibration curves indicated good agreement between predicted and actual survival rates.
The SRC proportion influences the prognosis of GSRCC patients. The establishment of the prognostic prediction model will provide assistance for clinical decision-making and prognosis assessment.
印戒细胞(SRC)癌显著影响胃癌(GC)患者的预后,但SRC比例的影响常被忽视。本研究旨在阐明SRC比例与预后之间的关系,并构建具有SRC成分的胃癌患者(GSRCC)的预后预测模型。
收集2011年11月至2018年12月在安徽医科大学第一附属医院接受胃切除术的628例GSRCC患者的临床资料。患者被随机分为训练集(442例患者)和验证集(186例患者)。在训练集中确定预后危险因素,并建立列线图预测模型。在训练集和验证集上进行内部和外部验证。
SRC比例(风险比[HR]:9.569,P<0.001)、浸润深度(HR:6.838,P=0.001)、肿瘤大小(HR:1.573,P=0.044)和N分期(HR:6.511,P<0.001)是GSRCC的独立预后因素。列线图在预测1年、3年和5年总生存期(OS)方面表现优异,训练集中的AUC值分别为0.819、0.832和0.874,验证集中的AUC值分别为0.815、0.847和0.876。校准曲线表明预测生存率与实际生存率之间具有良好的一致性。
SRC比例影响GSRCC患者的预后。预后预测模型的建立将为临床决策和预后评估提供帮助。