BACKGROUND Gastric signet-ring cell carcinoma(GSRCC)is a more aggressive subtype of gastric cancer compared to gastric adenocarcinoma(GA),with an increasing incidence.However,the prognostic differences between these s...BACKGROUND Gastric signet-ring cell carcinoma(GSRCC)is a more aggressive subtype of gastric cancer compared to gastric adenocarcinoma(GA),with an increasing incidence.However,the prognostic differences between these subtypes,particularly in re-sectable cases,remain unclear.AIM To evaluate prognostic factors and develop a predictive model for GA and GSRCC patients undergoing curative resection.METHODS This retrospective cohort study included patients with GA and GSRCC who underwent curative surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,from 2011 to 2018.Propensity score ma-tching(PSM)(1:1)balanced the baseline characteristics.Prognostic factors were identified using univariate and multivariate Cox and least absolute shrinkage and selection operator(LASSO)regression analyses.Model performance was eva-luated through calibration curves,decision curve analysis(DCA),and time-dependent receiver operating characteristic curves.Subgroup analysis and Ka-plan-Meier survival curves were generated.RESULTS In a cohort of 3027 patients,the GSRCC group was characterized by a significantly higher prevalence of individuals under 60 years of age,females,cases with poor differentiation,and early-stage(stage I)disease(all P<0.001).After PSM,the baseline was balanced and 761 patients were retained in each group.Variables identified through univariate Cox regression were included in the LASSO regression analysis.Mul-tivariate Cox regression analysis identified age,tumor differentiation,tumor size,vascular invasion,and post-treatment nodal margin staging as independent prognostic factors.Subgroup analysis indicated a notably poorer prognosis for GSRCC in patients aged 60 and above(hazard ratio=1.36,P=0.025).The nomogram(C-index=0.755)exhibited greater predictive accuracy than tumor node metastasis(TNM)staging for 1-,3-,and 5-year overall survival(all P<0.001),and provided a higher clinical net benefit according to DCA.CONCLUSION This study systematically compared resectable GA and GSRCC,revealing no overall survival difference.However,GSRCC demonstrated a significantly elevated mortality risk in subgroups stratified by age and tumor size.Multivariate analysis identified age,differentiation,tumor size,vascular invasion,and TNM stage as independent prognostic factors.The nomogram integrates clinicopathological features for precise risk stratification,surpassing traditional TNM staging.展开更多
BACKGROUND Poorly cohesive gastric carcinomas are classified based on the proportion of signet-ring cell carcinoma(SRCC)components.In surgically resected gastric cancer,SRCC is diagnosed when the signet-ring cell(SRC)...BACKGROUND Poorly cohesive gastric carcinomas are classified based on the proportion of signet-ring cell carcinoma(SRCC)components.In surgically resected gastric cancer,SRCC is diagnosed when the signet-ring cell(SRC)component constitutes≥50%of the entire tumor,whereas poorly cohesive carcinoma(PCC)not otherwise specified is diagnosed when the proportion of the SRC component is<50%of the entire tumor.The SRCC proportion in PCC varies along the spectrum,and its prognostic significance in gastric cancer remains unclear.AIM To investigate how the proportion of SRCC affects tumor pathology,clinical outcomes,and prognosis and treatment decision-making.METHODS This retrospective study included 1066 patients with PCC who underwent gastric cancer surgery at Seoul National University Bundang Hospital from 2016 to 2023.Patients were classified into four groups based on the SRCC proportion:<10%,≥10%and<50%,≥50%and<90%,and≥90%.Clinicopathological and molecular data were compared between the groups.The correlation between SRCC proportion and pathological factors associated with indications for endoscopic resection in patients with early-stage gastric cancer(EGC)was analyzed.RESULTS A higher SRCC proportion was associated with smaller tumor size,lower tumor stage pathological tumor-nodemetastasis,and reduced rates of lymphatic,vascular,and neural invasion(P<0.001).Notably,the≥90%SRCC group exhibited the highest recurrence-free survival(P=0.0072)and overall survival(P=0.0002).In EGC,lower SRCC rates were correlated with increased ulceration,larger tumor size,and deeper submucosal invasion(P<0.001).CONCLUSION Higher SRCC proportions in the PCC correlate with lower tumor aggressiveness and improved prognosis.Its role in EGC should be validated as a factor influencing therapeutic strategies,including endoscopic submucosal dissection.展开更多
BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been publishe...BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.展开更多
BACKGROUND Composite tumors are neoplasms comprising two distinct,yet intermingling,cell populations.This paper reports a rare phenomenon where early gastric signet-ring cell carcinoma(SRCC)and gastric mucosa-associat...BACKGROUND Composite tumors are neoplasms comprising two distinct,yet intermingling,cell populations.This paper reports a rare phenomenon where early gastric signet-ring cell carcinoma(SRCC)and gastric mucosa-associated lymphoid tissue(MALT)lymphoma coexist within the same lesion.CASE SUMMARY A 40-year-old woman presented to the West China Hospital for examination,which revealed a whitish,shallow,and uneven mucosal lesion in the stomach.The lesion was diagnosed as a poorly differentiated adenocarcinoma,including SRCC with atypical lymphoid hyperplasia associated with Helicobacter pylori infection,based on histopathological examination of the biopsy specimen.The lesion was excised using segmental gastrectomy.However,histological exami-nation of the surgical specimen confirmed that it was a poorly differentiated gastric adenocarcinoma with features of SRCC and MALT lymphoma.These two entities were stage I and coexisted in the same lesion.CONCLUSION It is uncommon for gastric SRCC and MALT lymphoma to coexist without distinct borders.Surgical resection is effective for these lesions.展开更多
Gastric signet-ring cell carcinoma(GSRCC)is a subtype of gastric cancer with distinct phenotype and high risk of peritoneal metastasis.Studies have shown that early GSRCC has a good prognosis,while advanced GSRCC is i...Gastric signet-ring cell carcinoma(GSRCC)is a subtype of gastric cancer with distinct phenotype and high risk of peritoneal metastasis.Studies have shown that early GSRCC has a good prognosis,while advanced GSRCC is insensitive to radiotherapy,chemotherapy or immune checkpoint blockade therapy.With technological advancement of single-cell RNA sequencing analysis and cytometry by time of flight mass cytometry,more detailed atlas of tumor microenvironment(TME)in GSRCC and its association with prognosis could be investigated extensively.Recently,two single-cell RNA sequencing studies revealed that GSRCC harbored a unique TME,manifested as highly immunosuppressive,leading to high immune escape.The TME of advanced GSRCC was enriched for immunosuppressive factors,including the loss of CXCL13+-cluster of differentiation 8+-Tex cells and declined clonal crosstalk among populations of T and B cells.In addition,GSRCC was mainly infiltrated by follicular B cells.The increased proportion of SRCC was accompanied by a decrease in mucosaassociated lymphoid tissue-derived B cells and a significant increase in follicular B cells,which may be one of the reasons for the poor prognosis of GSRCC.By understanding the relationship between immunosuppressive TME and poor prognosis in GSRCC and the underlying mechanism,more effective immunotherapy strategies and improved treatment outcomes of GSRCC can be anticipated.展开更多
A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy.Four years prior,she was diagnosed with a Helicobacter pylori infection but no eradication was performed.The p...A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy.Four years prior,she was diagnosed with a Helicobacter pylori infection but no eradication was performed.The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma.Endoscopic submucosal dissection(ESD)was performed.Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae.These tumor cells expressed focally pepsinogen-Ⅰ,diffusely MUC6,and scattered H^+/K^+ATPase according to immunohistochemistry.Therefore,we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG).Adjacent to the GA-FG,proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed.Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma.To the best of our knowledge,this is the first case report of GA-FG with a signet-ring cell carcinoma component.The origin of signet-ring cell carcinoma,i.e.,whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present.We expect the accumulation of similar cases and further analysis to clarify this issue.展开更多
Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphati...Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen （ER） and progesterone receptors （PR） and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a highgrade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases （Krukenberg＇s tumor）. A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.展开更多
Objective： To analyze the differences in clinicopathologic characteristics and prognosis between mucinous gastric carcinoma （MGC） and signet-ring cell carcinoma （SRCC）. Methods： Clinicopathologic and prognostic ...Objective： To analyze the differences in clinicopathologic characteristics and prognosis between mucinous gastric carcinoma （MGC） and signet-ring cell carcinoma （SRCC）. Methods： Clinicopathologic and prognostic data of 1,637 patients with histologically confirmed MGC or SRCC who received surgical operations in the Department of Gastroenterological Surgery, Beijing Cancer Hospital between December 2004 and December 2009 were retrospectively collected and analyzed. The clinicopathological features were analyzed statistically using Z2 test. Survival was analyzed using the Kaplan- Meier method and multivariate analysis of Cox proportional hazards regression model （backward, stepwise）. Results： A total of 181 patients with gastric cancer （74 MGC, 107 SRCC） were included. MGC, when compared with SRCC, was featured by senile patients, stage III and I~, upper third stomach, large tumor size, positive lymph node metastasis, and positive lymphatic vascular invasion （P〈0.05）. The overall 5-year survival rate showed no difference between the two groups （48.8% vs. 44.8%, P〉0.05）. However, the survival rate for MGC patients was significant lower than that for SRCC patients when compared among the age 〈60 years, negative distant metastasis, and tumor localized at upper third stomach （P〈0.05）. Multivariate Cox proportional hazards models revealed that distant metastasis was a significant independent prognostic indicator in MGC group, and lymph node metastasis and distant metastasis was significant independent prognostic indicators in SRCC group. Conclusions： While compared with SRCC, MGC is associated with a more aggressive tumor biologic behavior. There is no statistically significant difference in distant metastasis, an independent prognostic indicator for both MGC and SRCC, which might be the reason for no significant difference of the overall survival rate between the patients with MGC and SRCC.展开更多
BACKGROUND Signet-ring cell carcinoma(SRCC)was previously thought to have a worse prognosis than other differentiated gastric cancer(GC),however,recent studies have shown that the prognosis of SRCC is related to patho...BACKGROUND Signet-ring cell carcinoma(SRCC)was previously thought to have a worse prognosis than other differentiated gastric cancer(GC),however,recent studies have shown that the prognosis of SRCC is related to pathological type.We hypothesize that patients with SRCC and with different SRCC pathological components have different probability of lymph node metastasis(LNM).AIM To establish models to predict LNM in early GC(EGC),including early gastric SRCC.METHODS Clinical data from EGC patients who had undergone gastrectomy at the First Affiliated Hospital of Nanjing Medical University from January 2012 to March 2022 were reviewed.The patients were divided into three groups based on type:Pure SRCC,mixed SRCC,and non-signet ring cell carcinoma(NSRC).The risk factors were identified through statistical tests using SPSS 23.0,R,and EmpowerStats software.RESULTS A total of 1922 subjects with EGC were enrolled in this study,and included 249 SRCC patients and 1673 NSRC patients,while 278 of the patients(14.46%)presented with LNM.Multivariable analysis showed that gender,tumor size,depth of invasion,lymphovascular invasion,ulceration,and histological subtype were independent risk factors for LNM in EGC.Establishment and analysis using prediction models of EGC showed that the artificial neural network model was better than the logistic regression model in terms of sensitivity and accuracy(98.0%vs 58.1%,P=0.034;88.4%vs 86.8%,P<0.001,respectively).Among the 249 SRCC patients,LNM was more common in mixed(35.06%)rather than in pure SRCC(8.42%,P<0.001).The area under the ROC curve of the logistic regression model for LNM in SRCC was 0.760(95%CI:0.682-0.843),while the area under the operating characteristic curve of the internal validation set was 0.734(95%CI:0.643-0.826).The subgroups analysis of pure types showed that LNM was more common in patients with a tumor size>2 cm(OR=5.422,P=0.038).CONCLUSION A validated prediction model was developed to recognize the risk of LNM in EGC and early gastric SRCC,which can aid in pre-surgical decision making of the best method of treatment for patients.展开更多
An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing ...An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.展开更多
Signet-ring cell carcinoma(SRCC) of ampulla of Vater is extremely uncommon,and less than 15 cases have been reported so far in literature.It mainly occurs in elderly people(median age 57 years).We report a rare case o...Signet-ring cell carcinoma(SRCC) of ampulla of Vater is extremely uncommon,and less than 15 cases have been reported so far in literature.It mainly occurs in elderly people(median age 57 years).We report a rare case of SRCC of the ampulla of Vater in a 38-year-old woman who presented with a small tumor at the Vater,discovered by the contrast-enhanced ultrasound(CEUS).Histopathological examination showed prominent signet-ring features.We also describe the imaging features of SRCC of ampulla of Vater in CEUS.展开更多
AIM： To analyze the expression profiles of a human gastriccancer-related gene, GCRG123, in human gastric signetring cell carcinoma tissues, and to perform bioinformatics analysis on GCRG123.METHODS： In situ hybridiz...AIM： To analyze the expression profiles of a human gastriccancer-related gene, GCRG123, in human gastric signetring cell carcinoma tissues, and to perform bioinformatics analysis on GCRG123.METHODS： In situ hybridization was used to explore the GCRG123 expression pattern in paraffin-embedded gastric tissues, including 15 cases of signet-ring cell carcinoma, 15 of intestinal-type adenocarcinoma, and 15 of normal gastric mucosa. Northern blotting was used to analyze the differences in GCRG123 expression between stomach signet-ring cell carcinoma and intestinal-type adenocarcinoma tissues. Online software, including BLAST, Multalin and BLAT, were applied for bioinformatics analysis. National Center for Biotechnology Information （NCBI） and the University of California Santa Cruz （UCSC） databases were used for the analyses.RESULTS： The in situ hybridization signal appeared as blue precipitates restricted to the cytoplasm. Ten out of 15 cases of gastric signet ring cell carcinoma, normal gastric mucosal epithelium and pyloric glands showed high GCRG123 expression. Low GCRG123 expression was observed in gastric intestinal-type adenocarcinoma and normal gastric glands. Northern blotting revealed that GCRG123 was up-regulated in signet-ring cell carcinoma tissue but down-regulated in intestinal-type adenocarcinoma tissue. BLAST and Multalin analyses revealed that the GCRG123 sequence had 92% similarity with the ORF2 sequence of human long interspersed nuclear element retrotransposons （LINE-1, L1）. BLAT analysis indicated that GCRG123 mapped to all chromosomes. GCRG123 was found to integrate in the intron-17 and -23 of Rb, 5＇ flanking region of IL-2 and clotting factor Ⅸ genes.CONCLUSION： GCRG123, an active member of the Lt family, was up-regulated in human gastric signet-ring cell carcinoma.展开更多
A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion...A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.展开更多
Gastric signet-ring cell gastric carcinoma(GSRC)is an unfavorable subtype of gastric cancer(GC)that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC.However,GSRC in earl...Gastric signet-ring cell gastric carcinoma(GSRC)is an unfavorable subtype of gastric cancer(GC)that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC.However,GSRC in early stage is often considered an indicator of less lymph node metastasis and more satisfying clinical outcome compared to poorly differentiated GC.Therefore,the detection and diagnosis of GSRC at early stage undoubtedly play a crucial role in the management of GSRC patients.In recent years,technological advancement in endoscopy including narrow-band imaging and magnifying endoscopy has significantly improved the accuracy and sensitivity of the diagnosis under endoscopy for GSRC patients.Researches have confirmed that early stage GSRC that meets the expanded criteria of endoscopic resection showed comparable outcomes to surgery after receiving endoscopic submucosal dissection(ESD),indicating that ESD could be considered standard treatment for GSRC after thorough selection and evaluation.This article summarizes the current knowledge and updates pertaining to the endoscopic diagnosis and treatment of early stage signet-ring cell gastric carcinoma.展开更多
BACKGROUND Metastatic skin cancers are relatively rare dermatological malignancies.They usually present as nodules,erythematous lesions,scar-like lesions or other lesion types.Signet-ring cell carcinoma(SRCC)is an unc...BACKGROUND Metastatic skin cancers are relatively rare dermatological malignancies.They usually present as nodules,erythematous lesions,scar-like lesions or other lesion types.Signet-ring cell carcinoma(SRCC)is an uncommon histological type of gastric cancer that usually behaves aggressively and has a poor prognosis.Skin metastasis may be the first sign of clinically silent visceral cancer or recurrence of an internal malignancy.CASE SUMMARY Herein we report on the case of a 55-year-old man with edema of a lower extremity as the primary symptom which progressed from local to generalized pitting edema in the year following skin involvement.Pathological evidence from gastroscopic specimens and subcutaneous tissue biopsy showed typical signetring cells and gland-like structures.Consistently,immunohistochemical analysis revealed positive pan-cytokeratin expression in tumor cells.A diagnosis of gastric SRCC with skin metastasis was established.Moreover,lymphoscintigraphy showed an obvious accumulation of radiotracer on the anterior and posterior sides of the right leg which indicated lymphedema.We reviewed the relevant literature on subcutaneous metastases of gastric SRCC.CONCLUSION This rare case emphasizes the importance of physical examination as it may help elucidate the etiology of edema.展开更多
We report the case of a 40-year-old female Chinese patient with gastric signet-ring cell carcinoma that was first diagnosed because of paraneoplastic eosinophilia.The patient’s eosinophil count reduced markedly to no...We report the case of a 40-year-old female Chinese patient with gastric signet-ring cell carcinoma that was first diagnosed because of paraneoplastic eosinophilia.The patient’s eosinophil count reduced markedly to normal levels within 24 h after radical gastrectomy and Billroth II anastomosis.The patient recovered well after the surgery and no abnormalities were found during the regular follow-ups.Paraneoplastic eosinophilia is an unusual manifestation that usually remains asymptomatic;moreover,cases of solid malignant tumors with eosinophilia are uncommon.To our knowledge,this is the first reported case of paraneoplastic eosinophilia in a patient with gastric carcinoma.We considered eosinophilia as a manifestation of a paraneoplastic syndrome,which can be the first clinical manifestation of a malignancy.展开更多
While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gas...While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer,which can be resected endoscopically in some cases and which has a better outcome than non-SRCC,and advanced gastric cancer,which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. However,the prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. It therefore remains unclear if a specific therapeutic strategy is justified,as the benefit of perioperative chemotherapy and the value of taxanebased chemotherapy are unclear. In this review we analyze recent data on the epidemiology,oncogenesis,prognosis and specific therapeutic strategies in both early and advanced SRCC of the stomach and in hereditary diffuse gastric cancer.展开更多
Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarc...Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarcinoma.Here we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the stomach.The tumor was completely excised by endoscopic snare polypectomy.FGPs should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.展开更多
Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only ...Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types - colorectal mucinous, signet-ring cell, and non-mucinous adenocarcinoma, to clarify the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies. Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients （P 〈0.001）. Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma （P 〈0.001）. Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion （P 〈0.01）. The rate of radical resection, hepatic metastasis and local recurrence did not differ among types （P 〉0.05）. Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰ or Ⅳ disease （P 〉0.05）. Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior. Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.展开更多
BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present ...BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present an 88-year-old man with appendiceal SRCC with terminal ileum metastasis.The tumour stage was stage pT4bN2M1bG3 IVB,and the Tumour,Node,Metastasis staging system was used.The patient was admitted to our hospital on 12 July,2022 and underwent laparoscopic appendectomy under general anaesthesia after the examination.The pathological examination that took place 1 week after the operation showed that SRCC of the appendix invaded the whole layer,vessels and nerves of the appendix wall.It was suggested that the primary appendix should be considered after excluding metastasis.Based on the postoperative pathology findings,the patient underwent a secondary surgery on 2 August,2022.The second pathological examination showed residual SRCC in the appendiceal area of the ileocecal region,which infiltrated the serosal fibres and adipose tissue of the ileocecal region to the surface mesothelium.The tumour infiltrated the whole layer of the ileum wall,serosa fibres,adipose tissue and the surface mesothelium.Postoperative follow-up showed no signs of tumour recurrence or metastasis.CONCLUSION In clinical practice,a heightened awareness of rare diseases,coupled with thorough intraoperative exploration and rapid pathological examination,enables more accurate judgments,potentially sparing patients from unnecessary secondary surgery and ensuring optimal treatment.展开更多
基金Supported by the National Natural Science Foundation of China,No.82473285Beijing Hope Run Special Fund of Cancer Foundation of China,No.LC2022B02.
文摘BACKGROUND Gastric signet-ring cell carcinoma(GSRCC)is a more aggressive subtype of gastric cancer compared to gastric adenocarcinoma(GA),with an increasing incidence.However,the prognostic differences between these subtypes,particularly in re-sectable cases,remain unclear.AIM To evaluate prognostic factors and develop a predictive model for GA and GSRCC patients undergoing curative resection.METHODS This retrospective cohort study included patients with GA and GSRCC who underwent curative surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,from 2011 to 2018.Propensity score ma-tching(PSM)(1:1)balanced the baseline characteristics.Prognostic factors were identified using univariate and multivariate Cox and least absolute shrinkage and selection operator(LASSO)regression analyses.Model performance was eva-luated through calibration curves,decision curve analysis(DCA),and time-dependent receiver operating characteristic curves.Subgroup analysis and Ka-plan-Meier survival curves were generated.RESULTS In a cohort of 3027 patients,the GSRCC group was characterized by a significantly higher prevalence of individuals under 60 years of age,females,cases with poor differentiation,and early-stage(stage I)disease(all P<0.001).After PSM,the baseline was balanced and 761 patients were retained in each group.Variables identified through univariate Cox regression were included in the LASSO regression analysis.Mul-tivariate Cox regression analysis identified age,tumor differentiation,tumor size,vascular invasion,and post-treatment nodal margin staging as independent prognostic factors.Subgroup analysis indicated a notably poorer prognosis for GSRCC in patients aged 60 and above(hazard ratio=1.36,P=0.025).The nomogram(C-index=0.755)exhibited greater predictive accuracy than tumor node metastasis(TNM)staging for 1-,3-,and 5-year overall survival(all P<0.001),and provided a higher clinical net benefit according to DCA.CONCLUSION This study systematically compared resectable GA and GSRCC,revealing no overall survival difference.However,GSRCC demonstrated a significantly elevated mortality risk in subgroups stratified by age and tumor size.Multivariate analysis identified age,differentiation,tumor size,vascular invasion,and TNM stage as independent prognostic factors.The nomogram integrates clinicopathological features for precise risk stratification,surpassing traditional TNM staging.
文摘BACKGROUND Poorly cohesive gastric carcinomas are classified based on the proportion of signet-ring cell carcinoma(SRCC)components.In surgically resected gastric cancer,SRCC is diagnosed when the signet-ring cell(SRC)component constitutes≥50%of the entire tumor,whereas poorly cohesive carcinoma(PCC)not otherwise specified is diagnosed when the proportion of the SRC component is<50%of the entire tumor.The SRCC proportion in PCC varies along the spectrum,and its prognostic significance in gastric cancer remains unclear.AIM To investigate how the proportion of SRCC affects tumor pathology,clinical outcomes,and prognosis and treatment decision-making.METHODS This retrospective study included 1066 patients with PCC who underwent gastric cancer surgery at Seoul National University Bundang Hospital from 2016 to 2023.Patients were classified into four groups based on the SRCC proportion:<10%,≥10%and<50%,≥50%and<90%,and≥90%.Clinicopathological and molecular data were compared between the groups.The correlation between SRCC proportion and pathological factors associated with indications for endoscopic resection in patients with early-stage gastric cancer(EGC)was analyzed.RESULTS A higher SRCC proportion was associated with smaller tumor size,lower tumor stage pathological tumor-nodemetastasis,and reduced rates of lymphatic,vascular,and neural invasion(P<0.001).Notably,the≥90%SRCC group exhibited the highest recurrence-free survival(P=0.0072)and overall survival(P=0.0002).In EGC,lower SRCC rates were correlated with increased ulceration,larger tumor size,and deeper submucosal invasion(P<0.001).CONCLUSION Higher SRCC proportions in the PCC correlate with lower tumor aggressiveness and improved prognosis.Its role in EGC should be validated as a factor influencing therapeutic strategies,including endoscopic submucosal dissection.
文摘BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.
基金Supported by National Natural Science Foundation of China,No.82173253.
文摘BACKGROUND Composite tumors are neoplasms comprising two distinct,yet intermingling,cell populations.This paper reports a rare phenomenon where early gastric signet-ring cell carcinoma(SRCC)and gastric mucosa-associated lymphoid tissue(MALT)lymphoma coexist within the same lesion.CASE SUMMARY A 40-year-old woman presented to the West China Hospital for examination,which revealed a whitish,shallow,and uneven mucosal lesion in the stomach.The lesion was diagnosed as a poorly differentiated adenocarcinoma,including SRCC with atypical lymphoid hyperplasia associated with Helicobacter pylori infection,based on histopathological examination of the biopsy specimen.The lesion was excised using segmental gastrectomy.However,histological exami-nation of the surgical specimen confirmed that it was a poorly differentiated gastric adenocarcinoma with features of SRCC and MALT lymphoma.These two entities were stage I and coexisted in the same lesion.CONCLUSION It is uncommon for gastric SRCC and MALT lymphoma to coexist without distinct borders.Surgical resection is effective for these lesions.
基金Supported by the Zhejiang Provincial Natural Science Foundation of China,No.LTGC23H200005 and No.LQ19H160017the Medical Science and Technology Project of Zhejiang Province,China,No.2022RC167.
文摘Gastric signet-ring cell carcinoma(GSRCC)is a subtype of gastric cancer with distinct phenotype and high risk of peritoneal metastasis.Studies have shown that early GSRCC has a good prognosis,while advanced GSRCC is insensitive to radiotherapy,chemotherapy or immune checkpoint blockade therapy.With technological advancement of single-cell RNA sequencing analysis and cytometry by time of flight mass cytometry,more detailed atlas of tumor microenvironment(TME)in GSRCC and its association with prognosis could be investigated extensively.Recently,two single-cell RNA sequencing studies revealed that GSRCC harbored a unique TME,manifested as highly immunosuppressive,leading to high immune escape.The TME of advanced GSRCC was enriched for immunosuppressive factors,including the loss of CXCL13+-cluster of differentiation 8+-Tex cells and declined clonal crosstalk among populations of T and B cells.In addition,GSRCC was mainly infiltrated by follicular B cells.The increased proportion of SRCC was accompanied by a decrease in mucosaassociated lymphoid tissue-derived B cells and a significant increase in follicular B cells,which may be one of the reasons for the poor prognosis of GSRCC.By understanding the relationship between immunosuppressive TME and poor prognosis in GSRCC and the underlying mechanism,more effective immunotherapy strategies and improved treatment outcomes of GSRCC can be anticipated.
文摘A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy.Four years prior,she was diagnosed with a Helicobacter pylori infection but no eradication was performed.The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma.Endoscopic submucosal dissection(ESD)was performed.Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae.These tumor cells expressed focally pepsinogen-Ⅰ,diffusely MUC6,and scattered H^+/K^+ATPase according to immunohistochemistry.Therefore,we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG).Adjacent to the GA-FG,proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed.Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma.To the best of our knowledge,this is the first case report of GA-FG with a signet-ring cell carcinoma component.The origin of signet-ring cell carcinoma,i.e.,whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present.We expect the accumulation of similar cases and further analysis to clarify this issue.
文摘Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen （ER） and progesterone receptors （PR） and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a highgrade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases （Krukenberg＇s tumor）. A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.
文摘Objective： To analyze the differences in clinicopathologic characteristics and prognosis between mucinous gastric carcinoma （MGC） and signet-ring cell carcinoma （SRCC）. Methods： Clinicopathologic and prognostic data of 1,637 patients with histologically confirmed MGC or SRCC who received surgical operations in the Department of Gastroenterological Surgery, Beijing Cancer Hospital between December 2004 and December 2009 were retrospectively collected and analyzed. The clinicopathological features were analyzed statistically using Z2 test. Survival was analyzed using the Kaplan- Meier method and multivariate analysis of Cox proportional hazards regression model （backward, stepwise）. Results： A total of 181 patients with gastric cancer （74 MGC, 107 SRCC） were included. MGC, when compared with SRCC, was featured by senile patients, stage III and I~, upper third stomach, large tumor size, positive lymph node metastasis, and positive lymphatic vascular invasion （P〈0.05）. The overall 5-year survival rate showed no difference between the two groups （48.8% vs. 44.8%, P〉0.05）. However, the survival rate for MGC patients was significant lower than that for SRCC patients when compared among the age 〈60 years, negative distant metastasis, and tumor localized at upper third stomach （P〈0.05）. Multivariate Cox proportional hazards models revealed that distant metastasis was a significant independent prognostic indicator in MGC group, and lymph node metastasis and distant metastasis was significant independent prognostic indicators in SRCC group. Conclusions： While compared with SRCC, MGC is associated with a more aggressive tumor biologic behavior. There is no statistically significant difference in distant metastasis, an independent prognostic indicator for both MGC and SRCC, which might be the reason for no significant difference of the overall survival rate between the patients with MGC and SRCC.
基金National Natural Science Foundation of China,No.82200625 and No.82100595Youth Talent Development Program,No.YNRCQN0313+2 种基金Young Scholar Fostering Fund of the First Affiliated Hospital of Nanjing Medical University,No.PY2021023Top Talent of Changzhou“The 14th Five-Year Plan”High-Level Health Talents Training Project,No.2022CZBJ051Natural Science Foundation of Jiangsu Province,China,No.BK20210958.
文摘BACKGROUND Signet-ring cell carcinoma(SRCC)was previously thought to have a worse prognosis than other differentiated gastric cancer(GC),however,recent studies have shown that the prognosis of SRCC is related to pathological type.We hypothesize that patients with SRCC and with different SRCC pathological components have different probability of lymph node metastasis(LNM).AIM To establish models to predict LNM in early GC(EGC),including early gastric SRCC.METHODS Clinical data from EGC patients who had undergone gastrectomy at the First Affiliated Hospital of Nanjing Medical University from January 2012 to March 2022 were reviewed.The patients were divided into three groups based on type:Pure SRCC,mixed SRCC,and non-signet ring cell carcinoma(NSRC).The risk factors were identified through statistical tests using SPSS 23.0,R,and EmpowerStats software.RESULTS A total of 1922 subjects with EGC were enrolled in this study,and included 249 SRCC patients and 1673 NSRC patients,while 278 of the patients(14.46%)presented with LNM.Multivariable analysis showed that gender,tumor size,depth of invasion,lymphovascular invasion,ulceration,and histological subtype were independent risk factors for LNM in EGC.Establishment and analysis using prediction models of EGC showed that the artificial neural network model was better than the logistic regression model in terms of sensitivity and accuracy(98.0%vs 58.1%,P=0.034;88.4%vs 86.8%,P<0.001,respectively).Among the 249 SRCC patients,LNM was more common in mixed(35.06%)rather than in pure SRCC(8.42%,P<0.001).The area under the ROC curve of the logistic regression model for LNM in SRCC was 0.760(95%CI:0.682-0.843),while the area under the operating characteristic curve of the internal validation set was 0.734(95%CI:0.643-0.826).The subgroups analysis of pure types showed that LNM was more common in patients with a tumor size>2 cm(OR=5.422,P=0.038).CONCLUSION A validated prediction model was developed to recognize the risk of LNM in EGC and early gastric SRCC,which can aid in pre-surgical decision making of the best method of treatment for patients.
文摘An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.
基金Supported by The Educational Fund of Liaoning Province,No.2008795
文摘Signet-ring cell carcinoma(SRCC) of ampulla of Vater is extremely uncommon,and less than 15 cases have been reported so far in literature.It mainly occurs in elderly people(median age 57 years).We report a rare case of SRCC of the ampulla of Vater in a 38-year-old woman who presented with a small tumor at the Vater,discovered by the contrast-enhanced ultrasound(CEUS).Histopathological examination showed prominent signet-ring features.We also describe the imaging features of SRCC of ampulla of Vater in CEUS.
基金the Key Project from the 10th Five-year Plan of Chinese PLA, No. 01Z035International Cooperation Project from the 11th Five-year Plan of Chinese PLA, No. 06H044
文摘AIM： To analyze the expression profiles of a human gastriccancer-related gene, GCRG123, in human gastric signetring cell carcinoma tissues, and to perform bioinformatics analysis on GCRG123.METHODS： In situ hybridization was used to explore the GCRG123 expression pattern in paraffin-embedded gastric tissues, including 15 cases of signet-ring cell carcinoma, 15 of intestinal-type adenocarcinoma, and 15 of normal gastric mucosa. Northern blotting was used to analyze the differences in GCRG123 expression between stomach signet-ring cell carcinoma and intestinal-type adenocarcinoma tissues. Online software, including BLAST, Multalin and BLAT, were applied for bioinformatics analysis. National Center for Biotechnology Information （NCBI） and the University of California Santa Cruz （UCSC） databases were used for the analyses.RESULTS： The in situ hybridization signal appeared as blue precipitates restricted to the cytoplasm. Ten out of 15 cases of gastric signet ring cell carcinoma, normal gastric mucosal epithelium and pyloric glands showed high GCRG123 expression. Low GCRG123 expression was observed in gastric intestinal-type adenocarcinoma and normal gastric glands. Northern blotting revealed that GCRG123 was up-regulated in signet-ring cell carcinoma tissue but down-regulated in intestinal-type adenocarcinoma tissue. BLAST and Multalin analyses revealed that the GCRG123 sequence had 92% similarity with the ORF2 sequence of human long interspersed nuclear element retrotransposons （LINE-1, L1）. BLAT analysis indicated that GCRG123 mapped to all chromosomes. GCRG123 was found to integrate in the intron-17 and -23 of Rb, 5＇ flanking region of IL-2 and clotting factor Ⅸ genes.CONCLUSION： GCRG123, an active member of the Lt family, was up-regulated in human gastric signet-ring cell carcinoma.
文摘A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.
文摘Gastric signet-ring cell gastric carcinoma(GSRC)is an unfavorable subtype of gastric cancer(GC)that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC.However,GSRC in early stage is often considered an indicator of less lymph node metastasis and more satisfying clinical outcome compared to poorly differentiated GC.Therefore,the detection and diagnosis of GSRC at early stage undoubtedly play a crucial role in the management of GSRC patients.In recent years,technological advancement in endoscopy including narrow-band imaging and magnifying endoscopy has significantly improved the accuracy and sensitivity of the diagnosis under endoscopy for GSRC patients.Researches have confirmed that early stage GSRC that meets the expanded criteria of endoscopic resection showed comparable outcomes to surgery after receiving endoscopic submucosal dissection(ESD),indicating that ESD could be considered standard treatment for GSRC after thorough selection and evaluation.This article summarizes the current knowledge and updates pertaining to the endoscopic diagnosis and treatment of early stage signet-ring cell gastric carcinoma.
基金The National Nature Science Foundation of China,No.81900363.
文摘BACKGROUND Metastatic skin cancers are relatively rare dermatological malignancies.They usually present as nodules,erythematous lesions,scar-like lesions or other lesion types.Signet-ring cell carcinoma(SRCC)is an uncommon histological type of gastric cancer that usually behaves aggressively and has a poor prognosis.Skin metastasis may be the first sign of clinically silent visceral cancer or recurrence of an internal malignancy.CASE SUMMARY Herein we report on the case of a 55-year-old man with edema of a lower extremity as the primary symptom which progressed from local to generalized pitting edema in the year following skin involvement.Pathological evidence from gastroscopic specimens and subcutaneous tissue biopsy showed typical signetring cells and gland-like structures.Consistently,immunohistochemical analysis revealed positive pan-cytokeratin expression in tumor cells.A diagnosis of gastric SRCC with skin metastasis was established.Moreover,lymphoscintigraphy showed an obvious accumulation of radiotracer on the anterior and posterior sides of the right leg which indicated lymphedema.We reviewed the relevant literature on subcutaneous metastases of gastric SRCC.CONCLUSION This rare case emphasizes the importance of physical examination as it may help elucidate the etiology of edema.
文摘We report the case of a 40-year-old female Chinese patient with gastric signet-ring cell carcinoma that was first diagnosed because of paraneoplastic eosinophilia.The patient’s eosinophil count reduced markedly to normal levels within 24 h after radical gastrectomy and Billroth II anastomosis.The patient recovered well after the surgery and no abnormalities were found during the regular follow-ups.Paraneoplastic eosinophilia is an unusual manifestation that usually remains asymptomatic;moreover,cases of solid malignant tumors with eosinophilia are uncommon.To our knowledge,this is the first reported case of paraneoplastic eosinophilia in a patient with gastric carcinoma.We considered eosinophilia as a manifestation of a paraneoplastic syndrome,which can be the first clinical manifestation of a malignancy.
文摘While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer,which can be resected endoscopically in some cases and which has a better outcome than non-SRCC,and advanced gastric cancer,which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. However,the prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. It therefore remains unclear if a specific therapeutic strategy is justified,as the benefit of perioperative chemotherapy and the value of taxanebased chemotherapy are unclear. In this review we analyze recent data on the epidemiology,oncogenesis,prognosis and specific therapeutic strategies in both early and advanced SRCC of the stomach and in hereditary diffuse gastric cancer.
文摘Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarcinoma.Here we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the stomach.The tumor was completely excised by endoscopic snare polypectomy.FGPs should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.
文摘Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types - colorectal mucinous, signet-ring cell, and non-mucinous adenocarcinoma, to clarify the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies. Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients （P 〈0.001）. Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma （P 〈0.001）. Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion （P 〈0.01）. The rate of radical resection, hepatic metastasis and local recurrence did not differ among types （P 〉0.05）. Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰ or Ⅳ disease （P 〉0.05）. Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior. Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.
文摘BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present an 88-year-old man with appendiceal SRCC with terminal ileum metastasis.The tumour stage was stage pT4bN2M1bG3 IVB,and the Tumour,Node,Metastasis staging system was used.The patient was admitted to our hospital on 12 July,2022 and underwent laparoscopic appendectomy under general anaesthesia after the examination.The pathological examination that took place 1 week after the operation showed that SRCC of the appendix invaded the whole layer,vessels and nerves of the appendix wall.It was suggested that the primary appendix should be considered after excluding metastasis.Based on the postoperative pathology findings,the patient underwent a secondary surgery on 2 August,2022.The second pathological examination showed residual SRCC in the appendiceal area of the ileocecal region,which infiltrated the serosal fibres and adipose tissue of the ileocecal region to the surface mesothelium.The tumour infiltrated the whole layer of the ileum wall,serosa fibres,adipose tissue and the surface mesothelium.Postoperative follow-up showed no signs of tumour recurrence or metastasis.CONCLUSION In clinical practice,a heightened awareness of rare diseases,coupled with thorough intraoperative exploration and rapid pathological examination,enables more accurate judgments,potentially sparing patients from unnecessary secondary surgery and ensuring optimal treatment.
