| Objective: To study the influencing factors of gastric signet ring cell carcinoma prognosis and the differences and prognosis between the clinical and pathological features of Borrmann type IV and non-Borrmann type IV in gastric signet ring cell carcinoma.Methods: The clinical data of 138 patients with gastric signet ring cell carcinoma who underwent surgical treatment from May 2010 to May 2015 were collected and statistically analyzed using SPSS22.0 statistical software.P <0.05 was statistically different.COX regression model was used to analyze the factors affecting the prognosis of patients.Kaplan-Meier survival analysis was performed on 127 patients with signet ring cell carcinoma who were effectively followed up.Log-Rank tests were performed between survival curves.Result:1.Univariate analysis showed that tumor site(P=0.039),tumor size(P= 0.000),T stage(P=0.000),surgical method(P=0.000),and pathological type(P = 0.000)affected patient prognosis;multiple factors Analysis showed that tumor size,T stage,and pathological type were independent risk factors affecting the prognosis of gastric signet ring cell carcinoma.2.The 3-year survival rate of patients with signet ring cell carcinoma in this study is approximately 36.9%.The 3-year survival rate of patients with total gastrectomy was about 12.8%;the 3-year survival rate of patients with partial gastrectomy was about 46.5%(P=0.000).The stratified analysis showed that there was no significant correlation between the surgical approach and TNM stage I and II patients(P> 0.05);in stage III patients,patients with total gastrectomy had poor prognosis(P=0.000).3.Diffuse invasive and non-invasive invasive gastric signet ring cell carcinomas(grouped by Borrmann classification)are not statistically significant at the age of onset(P = 0.095)and gender(P = 0.404).The former mainly invades the whole stomach(48.15%).),Most of the remaining lesions(29.63%)are more common in the gastric body and gastric antrum,but fewer cases occur in the cardia and fundus;the latter is more diverse,the most common site is the gastric antrum(33.33%)And stomach body(27.02%),only 7.21% invaded the whole stomach,and the other part was located in the fundus and the cardia.The tumor diameter of diffuse invasive gastric SRCC was 10.07 ± 4.60 cm,and the tumor diameter of non-diffusive invasive SRCC was 5.70 ± 3.33 cm.The former was much larger than the latter,and the two were statistically significant(P = 0.001).In all diffuse invasive gastric SRCCs,the depth of lesion infiltration has exceeded the submucosal layer,and more than 90% of cases have reached stage T4.In the non-diffusive invasive gastric SRCC types,there are 22.52% limitations of gastric signet ring cell carcinoma.In the mucosa and submucosa,T4 cases accounted for 70.27%.It can be seen that the T stage of diffusely infiltrating tumors was significantly later than that of non-diffusively infiltrating tumors(P = 0.006).In diffuse infiltrating SRCC,peripheral lymph node involvement is 14.81% in the N2 phase and 62.96% in the N3 phase;36.03% of patients in the latter have no peripheral lymph node metastasis.The proportion of patients in the N2 phase is about 24.32%,and N3 Stage cases accounted for about 27.03%,and the positive rate of lymph nodes in the former was significantly higher than that in the latter(P = 0.005).Conclusion:1.Tumor size,T stage,and pathological type are independent risk factors that influence the prognosis of gastric SRCC.2.Diffuse infiltrates and non-diffuse infiltrating SRCCs have very different characteristics in terms of tumorigenesis site and tumor size.Compared with non-diffuse infiltrating SRCCs,diffuse infiltrating SRCCs are mostly stage III gastric cancer.It is further proved that the prognosis of non-diffusive infiltrating SRCC is better than that of diffuse-infiltrating SRCC. |
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