Clinicopathlogic features and prognosis of the gastric signet ring cell carcinoma: a SEER database analysis / 医学研究生学报

ABSTRACT

Objective　Prognoses of late stage signet-ring cell carcinoma (SRCC) is usually worse than that in other gastric carcinoma. In the current study, SEER database were adopted to analyze the clinicopathologic features and prognoses of SRCC and non-signet-ring cell carcinoma (non SRCC), and to compare the differences in survival rate under different early treatments.　Methods　Clinical data of 5193 patients who were diagnosed with gastric carcinoma from 2010 to 2015 are collected from SEER. Patients are divided into two groups SRCC (n=2439) and non SRCC (n=2754) based on their histologic type. Differences in Gender, age, race, primary site, degree of differentiation, tumor size, depth of invasion, local lymph node metastasis, distant metastasis, tumor, node, metastasis (TNM) staging, operative treatment and chemotherapy were compared. Cox regression model was used to analyze prognostic factors. According to different operative treatment, patients in SRCC and non SRCC groups were divided into surgery group and surgery with adjuvant chemotherapy group, respectively. Kaplan-meier method was used to draw the survival curve, and Log-Rank test was adopted for survival analysis.　Results　Significant statistical difference (P<0.05) were found in the two gastric carcinoma groups regarding gender, age, race, primary site, degree of differentiation, tumor size, depth of invasion, local lymph node metastasis, distant metastasis, TNM staging, operative treatment and chemotherapy. The multivariate Cox regression analysis indicated that age (HR1.417; 95%CI1.273-1.578; P<0.05), race (HR0.91; 95%CI0.825-0.998; P<0.05), tumor size (HR1.28; 95%CI 1.199-1.365; P<0.05), depth of invasion (HR 1.252 95%CI 1.159-1.352; P<0.05), local lymph node metastasis (HR0.862; 95%CI 0.81-0.918; P<0.05), distant metastasis (HR 1.369 95%CI 1.069-1.753; P<0.05), TNM stage (HR1.342; 95%CI1.155-1.559; P<0.05), and surgical treatment (HR0.245; 95%CI 0.228-0.284; P<0.05) are independent risk factors affecting the prognosis of SRCC patients. The overall five-year survival rate of SRCC patients is 27.6% , which is lower than that of non SRCC patients (43.0%). Therefore, there is significant difference in statistics (P<0.05). Significant statistical difference was also found in stratification analysis of the five-year survival rates among SRCC surgery group, SRCC surgery with adjuvant chemotherapy group, non SRCC surgery group and non SRCC surgery with adjuvant chemotherapy group. The results indicated that the five-year survival rates of SRCC surgery with adjuvant chemotherapy group at stage TIN1M0 and stage T2N0M0 are both superior to that in the surgery group with statistical difference (P<0.05). In addition, the five-year survival rate of SRCC surgery with adjuvant chemotherapy group at T2N0M0 is superior to that in the non SRCC patients, with statistical difference (P<0.05).　Conclusion　SRCC patients present with unique clinicopathologic features. Early detection and treatment could improve the prognosis of SRCC patients.