Tung S Y, Wu C S, Chen P C
Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, China.
Am J Gastroenterol. 1996 Oct;91(10):2195-9.
To evaluate the differences of clinicopathological features between colorectal signet ring cell carcinoma and ordinary adenocarcinoma.
The clinicopathological data of 28 cases with primary colorectal signet ring cell carcinoma was reviewed and compared with the data from 56 age- and sex-matched patients with ordinary adenocarcinoma.
Fifteen cases (53.5%) with primary signet ring cell carcinoma were younger than 40 yr of age. Compared with 985 ordinary adenocarcinoma cases, signet ring cell carcinoma is present in excess in younger patients (p < 0.005). Further comparison with 56 age- and sex-matched ordinary adenocarcinomas showed that signet ring cell carcinomas could affect any sites of colon, presented as scirrhous appearance more frequently, had a higher percentage of stage III or IV tumors (78.6 vs 48.2%, 14.3 vs 7.2%, p < 0.005), had a higher rate of peritoneal seeding (35.7 vs 12.5%, p < 0.005) but a lower rate of liver metastasis (14.3 vs 32.1%, p < 0.005), and had a lower curative resection rate (64.2 vs 80.4%, p < 0.005) and a higher local or distant metastasis rate (61.1 vs 17.8%, p < 0.05). Survival with signet ring cell carcinoma is lower than that of ordinary adenocarcinoma. "Stage-on-diagnosis" and "presence of subsequent distant metastasis" were the major factors influencing survival of signet ring cell carcinoma patients.
The delay in diagnosis reduces the chance of curative resection, increases the possibility of local or distant metastasis postoperatively, and, thus, shortens the survival chances. To improve outcome, recognition of the factors responsible for this delay should be stressed so that this tumor may be found at a stage when cure is possible.
评估结直肠印戒细胞癌与普通腺癌临床病理特征的差异。
回顾性分析28例原发性结直肠印戒细胞癌患者的临床病理资料，并与56例年龄及性别相匹配的普通腺癌患者的数据进行比较。
15例（53.5%）原发性印戒细胞癌患者年龄小于40岁。与985例普通腺癌病例相比，印戒细胞癌在年轻患者中更为多见（p<0.005）。与56例年龄及性别相匹配的普通腺癌进一步比较显示，印戒细胞癌可发生于结肠的任何部位，更常表现为硬癌外观，Ⅲ期或Ⅳ期肿瘤的比例更高（78.6%对48.2%，14.3%对7.2%，p<0.005），腹膜种植率更高（35.7%对12.5%，p<0.005），但肝转移率更低（14.3%对32.1%，p<0.005），根治性切除率更低（64.2%对80.4%，p<0.005），局部或远处转移率更高（61.1%对17.8%，p<0.05）。印戒细胞癌患者的生存率低于普通腺癌患者。“确诊时的分期”和“随后发生远处转移”是影响印戒细胞癌患者生存的主要因素。
诊断延迟降低了根治性切除的机会，增加了术后局部或远处转移的可能性，从而缩短了生存机会。为改善治疗效果，应强调认识导致这种延迟的因素，以便在可能治愈的阶段发现这种肿瘤。
