The difference in clinic-pathological features between signet ring cell carcinoma and gastric mucinous adenocarcinoma
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RESEARCH ARTICLE
The difference in clinic-pathological features between signet ring cell carcinoma and gastric mucinous adenocarcinoma Hao Jiang & Hongfeng Zhang & Lantian Tian & Xi Zhang & Yingwei Xue
Received: 19 March 2013 / Accepted: 17 April 2013 # International Society of Oncology and BioMarkers (ISOBM) 2013
Abstract We investigated the clinical and pathological features as well as the prognosis of signet ring cell carcinoma (SRC) and gastric mucinous carcinoma (GMC) to lay a foundation for the management of these two diseases. Two thousand four hundred thirty gastric cancer patients, including 288 SRCs and 80 GMCs who had received a gastrectomy between 1997 and 2007, were retrospectively evaluated. There were significant differences in tumor location, distant metastasis status, lymph node dissection, depth of invasion, Borrmann type, pTNM stage, and pathological lymph node status between SRCs and GMC (P=0.001, 0.003, 0.01, 0.0002, 0.0013, 0.0001, and 0.265, respectively). After prognostic analysis, the cases with GMC received a relatively low 5-year specific survival rate compared to SRC (58.68 % vs. 66.25 %; P=0.064). After Cox regression analysis, gender, age, lymph node metastatic ratio, pTNM stage, curative operation, and distant metastasis were identified as the independent prognostic factors in SRC. On the other hand, pTNM stage and distant metastasis were identified as the independent prognostic factors in GMC. In conclusion, the clinical and pathological features as well as prognosis of GMC and gastric SRC differed. Therefore, the treatment of the two diseases should be individualized.
H. Jiang : H. Zhang : X. Zhang : Y. Xue (*) Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Harbin Medical University, Harbin, China 150040 e-mail: [email protected] L. Tian Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China 150001
Keywords Gastric tumor . SRC . GMC . Prognosis
Introduction The survival of patients with gastric cancer has recently improved because of early detection, rational lymphadenectomy and several therapeutic modalities [1–3]. However, gastric cancer still remains the second leading cause of cancer mortality in the world [4, 5]. Signet ring cell carcinoma (SRC) has been reported as histological-based only on the microscopic characteristics of the tumor, as described by the World Health Organization (WHO), but not on the biological behavior [6]. SRC has been reported to have a poor prognosis and the potential to infiltrate the stomach wall, and the Japanese Research Society of Gastric Cancer has designated SRC as an undifferentiated type [7]. At present, some researchers are investigating the clinicopathological features and prognosis of gastric SRC, but the results have been inconsistent [8, 9]. Gastric mucinous carcinoma (GMC) is usually detected in advanced tumors and is also designated as an undifferentiated type by the Japanese Research Society of Gastric Cancer [10]. The WHO defines GMC as a gastric a
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