Signet Ring Cell Mixed Histology May Show More Aggressive Behavior Than Other Histologies in Early Gastric Cancer
Authors
Cheal Wung Huh ; Da Hyun Jung ; Jie-Hyun Kim ; Yong Chan Lee ; Hyunki Kim ; Hoguen Kim ; Sun Och Yoon ; Young Hoon Youn ; Hyojin Park ; Sang In Lee ; Seung Ho Choi ; Jae-Ho Cheong ; Sung Hoon Noh
Citation
JOURNAL OF SURGICAL ONCOLOGY, Vol.107(2) : 124-129, 2013
Adenocarcinoma/diagnosis ; Adenocarcinoma/mortality ; Adenocarcinoma/pathology* ; Adenocarcinoma/surgery ; Adult ; Aged ; Carcinoma, Signet Ring Cell/diagnosis ; Carcinoma, Signet Ring Cell/mortality ; Carcinoma, Signet Ring Cell/pathology* ; Carcinoma, Signet Ring Cell/surgery ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasms, Complex and Mixed/diagnosis ; Neoplasms, Complex and Mixed/mortality ; Neoplasms, Complex and Mixed/pathology* ; Neoplasms, Complex and Mixed/surgery ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery
Keywords
biologic characteristics ; early gastric cancer ; signet ring cell carcinoma
Abstract
BACKGROUND:
Signet ring cell carcinoma (SRC) of the stomach is known to have different microscopic and biologic characteristics compared to non-SRC. The pathologic report has documented partly SRC component with main histologies. However, the clinical significance of SRC mixture has not been reported. Aim was to investigate clinicopathologic features of mixed-SRC histology in early gastric cancer (EGC).
METHODS:
Two thousand two hundred eight patients were diagnosed with EGC and underwent surgery. The patients were divided into three groups such as adenocarcinoma with partly SRC (mixed-SRC group), only adenocarcinoma (adenocarcinoma group), and SRC (SRC group). Clinicopathologic characteristics were compared.
RESULTS:
The SRC group was more associated with younger age, female, mid-body, mucosa-confined, depressed type, lower lymph node metastasis (LNM), lower lymphovascular invasion, and better survival rate than adenocarcinoma group. The mixed-SRC group was more associated with younger age, female, upper-body, and depressed type than adenocarcinoma group, similar to SRC group. However, the mixed-SRC group showed more submucosal invasion, larger size, and higher LNM than other groups. The mixed-SRC component was one of the independent risk factors of LNM.
CONCLUSIONS:
Mixed-SRC histology in EGC showed more aggressive behavior than other histologies. Clinical considerations of mixed-SRC histology may be helpful to decide on a specific cancer treatment.