Clinicopathologic Features And Prognostic Analysis Of Gastric Signet Ring Cell Carcinoma

Objective To investigate the clinicopathological features and prognosis of gastric signet ring cell carcinoma.Methods From January 2013 to June 2016,gastric signet ring cell cancer patients admitted to the First People's Hospital of Zhangjiagang City and the First Affiliated Hospital of Suzhou University were collected.The clinical data of the patients including age,sex,tumor size,location,depth of invasion,lymph node metastasis,infiltration of surrounding tissues,TNM staging,vascular invasion,nerve invasion,postoperative chemotherapy and other clinical data were retrospectively analyzed.Kaplan-Meier method was used to analyze the influence of various clinical factors on the survival rate of patients,and Cox regression model was used to analyze the prognostic risk factors of patients.Results A total of 218 GSRC patients were included in this study,of which 131 were female patients and 70%were patients younger than 60 years old.64 cases(29%)were cardia and fundus tumors,56 cases(26%)were gastric angle tumors,and 98 cases(45%)were gastric antrum tumors.There were 51 cases(23%)in early stage and 167 cases(77%)in advanced stage.The early stage of signet ring cell carcinoma is mainly characterized by local mucosal roughness and ulcer.Borrmann ? was the main manifestation in the advanced stage.Univariate analysis on prognosis of GSRC shows that the prognosis of early GSRC is related to tumor invasion depth,tumor size and lymph node involvement number.COX proportional hazards regression model shows that invasion depth(P=0.005)is an independent risk factor affecting early prognosis.Prognosis of advanced signet ring cell carcinoma is related to tumor size,depth of invasion,number of lymph nodes involved,metastasis of surrounding organs,TNM staging,vascular invasion and nerve invasion,and has nothing to do with gender,age,tumor location and postoperative chemotherapy.COX proportional hazards regression model showed that peripheral tissue infiltration(P=0.012),vascular invasion(P=0.008)and TNM staging(P=0.006)were independent risk factors affecting survival and prognosis of patients in advanced stage.Conclusion Gastric signet ring cell carcinoma is more common in young women,and it is more common in the middle and lower part of the stomach.there is no specific manifestation under early endoscopy.Borrmann ? is the most common type of the lower form of endoscopy in advanced stage.Prognosis of early gastric signet ring cell carcinoma is related to tumor invasion depth,tumor size and lymph node involvement number,of which invasion depth is an independent risk factor affecting early prognosis.Prognosis of advanced gastric signet ring cell carcinoma is related to tumor size,invasion depth,number of lymph nodes involved,metastasis of surrounding organs,TNM stage,vascular invasion and nerve invasion.Peripheral tissue invasion,vascular invasion and TNM stage are independent risk factors affecting survival and prognosis of advanced patients.