Clinical Significance Of Signet-ring Cell And Mucinous Component On The Prognosis Of Colorectal Cancer Patients

Background:We performed a retrospective study to determine the cancer-specific survival of colorectal cancer patients with a component of signet-ring cells or mucin comprising<50%of the tumor mass.Methods:A total of2454patients seen in our hospital from1985to2011were retrospectively studied. The patients were divided into five groups according to type of cancer:signet-ring cell carcinoma (with>50%signet-ring cell, n=36), partial signet-ring cell carcinoma (with<50%signet-ring cell, n=28), mucinous adenocarcinoma (with>50%mucin lacking signet-ring cell, n=267), partial mucinous adenocarcinoma (with<50%mucin lacking signet-ring cell, n=145), and classic adenocarcinoma (with absence of either mucin or signet-ring cell, n=1978).Results:Patients with>50%or<50%signet-ring cell had the lowest5-year survival rates (35.5%and29.7%, respectively), followed by patients with>50%mucin (48.8%). Patients who had partial mucinous adenocarcinoma with<50%mucin and classic adenocarcinoma patients had the highest5-year survival rates (64.8%and65.3%, respectively). Stratified and multivariate analysis showed that signet-ring cell carcinoma, partial signet-ring cell carcinoma and mucinous adenocarcinoma were independent predictors of decreased survival (hazard ratio1.699, P=0.016; hazard ratio2.182, P= 0.005; hazard ratio1.532, P<0.001; respectively), and partial mucinous adenocarcinoma was not (hazard ratio1.137, P=0.431).Conclusions:Patients with a component of signet-ring cells, regardless of the extent, had poor prognoses. Patients with mucinous adenocarcinoma containing>50%mucin had poor prognoses as well, whereas those with<50%mucin had survival rates similar to those of classic adenocarcinoma patients. Therefore, in clinical practice, patients with a component of signet-ring cells, regardless of the extent, should be given significant clinical attention.