Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 9:11:713587.
doi: 10.3389/fonc.2021.713587. eCollection 2021.

Prognostic Significance of Signet Ring Cells in Gastric Cancer: The Higher Proportion, The Better Survival

Yang Li  1 , Yuxin Zhong  1 , Quan Xu  1 , Zhikai Zhu  2 , Yantao Tian  1
Affiliations

Prognostic Significance of Signet Ring Cells in Gastric Cancer: The Higher Proportion, The Better Survival

Yang Li et al. Front Oncol. .

Abstract

Background: Due to the fact that the definition of gastric signet ring cell cancer (GSRC) was still controversial in the past decades, the prognosis affected by the proportion of signet ring cells within gastric cancer is uncertain. This study compared the clinicopathological features and prognosis of GSRC with the various proportions of signet ring cells.

Methods: We collected GSRC cases without metastasis who underwent curative (R0) resection between 2011 and 2018. Individuals who were in the low-proportion signet ring cell group (LSRC, <50%) were matched to those who were in the high-proportion signet ring cell group (HSRC, >50%) through propensity score matching (1:1). We used Cox proportional hazard regression to calculate the adjusted hazard ratios (HR) and 95% confidence intervals (CI) and explored interactions with gender and stage.

Results: We had 1:1 matched individuals including 231 cases from the LSRC group and 231 cases from the HSRC group. Patients with HSRC had a significantly higher overall survival rate in the multivariable model (aHR = 0.56, 95%CI = 0.38, 0.84) compared with those with LSRC. The association of HSRC appeared to be more substantial among individuals at early stage and N0 stage (p-interaction < 0.01).

Conclusions: This study confirms that GSRC with different proportions of signet ring cells could affect the survival of the patient. Further clinical studies should be developed in the future to provide an appropriate treatment strategy for GSRC.

Keywords: cancer survival; gastric cancer; prognosis; signet ring cell; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves for overall patients between low-proportion signet ring cells and high-proportion signet ring cells after matching.
Figure 2
Figure 2
Kaplan–Meier survival curves for patients by stage between low-proportion signet ring cells and high-proportion signet ring cells. (A) Early stage. (B) Advanced stage.
Figure 3
Figure 3
Kaplan–Meier survival curves for patients on stage N0 between low-proportion signet ring cells and high-proportion signet ring cells. (A) Before PSM. (B) After PSM. N0 means no positive lymph nodes. Conversely, N+ means extensive lymphatic involvement, which is a higher pathologic N stage.
Figure 4
Figure 4
Kaplan–Meier survival curves for patients with adjuvant chemotherapy between low-proportion signet ring cells LSRC and high-proportion signet ringcells. (A) Before PSM. (B) After PSM.
See this image and copyright information in PMC

References

    1. Lyons K, Le LC, Pham YTH, Borron C, Park JY, Tran CTD, et al. . Gastric Cancer: Epidemiology, Biology, and Prevention: A Mini Review. Eur J Cancer Prev (2019) 28(5):397–412. doi: 10.1097/CEJ.0000000000000480 - DOI - PubMed
    1. Thrift AP, El-Serag HB. Burden of Gastric Cancer. Clin Gastroenterol Hepatol (2020) 18(3):534–42. doi: 10.1016/j.cgh.2019.07.045 - DOI - PMC - PubMed
    1. Plummer M, Franceschi S, Vignat J, Forman D, de Martel C. Global Burden of Gastric Cancer Attributable to Helicobacter Pylori. Int J Cancer (2015) 136(2):487–90. doi: 10.1002/ijc.28999 - DOI - PubMed
    1. Arnold M, Abnet CC, Neale RE, Vignat J, Giovannucci EL, McGlynn KA, et al. . Global Burden of 5 Major Types Of Gastrointestinal Cancer. Gastroenterology (2020) 159(1):335–49.e15. doi: 10.1053/j.gastro.2020.02.068 - DOI - PMC - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin (2018) 68(6):394–424. doi: 10.3322/caac.21492 - DOI - PubMed