IDDF2019-ABS-0175 Differences in biologic behaviors between mixed and pure signet ring cell carcinoma in chinese early gastric cancer patients

Abstract

Background Signet ring cell carcinoma (SRC) of the stomach is a poorly differentiated cancer. Generally, poorly differentiated cancer is believed to show aggressive behavior and poor prognosis. There is no debate about that advanced SRC of the stomach has worse outcomes than does nonsignet ring cell adenocarcinoma (NSRC). However, the behavior of SRC carcinoma in early gastric cancer (EGC) is still controversial. This study aimed to compare clinicopathologic features between SRC and NSRC in Chinese early gastric cancer patients. Methods We reviewed medical records of patients with EGC who underwent surgical resection between 2009 and 2014 in a tertiary hospital in Jiangsu province, China. We divided EGC into (1) pure SRC carcinoma, which was defined as composed only of signet ring cells (2) mixed SRC carcinoma, defined as signet ring cell carcinoma that was mixed with other histological components and (3) NSRC. We reviewed the clinicopathologic features between these groups. Results A total of 1008 patients with early gastric cancer were enrolled. 163 patients (16.2%) were classified as SRC, including 63 cases of pure SRC and 100 mixed SRC. The SRC group was more associated with younger age, female, middle and lower location, mucosa-confined and LNM than NSRC group. Further stratification analyses according to the purity of SRC demonstrated that mixed SRC was associated with an increased risk of LVI (P = 0.03) and LNM (P Conclusions Mixed SRC in EGC showed more aggressive behavior than other histologies. Therefore, more attention should be paid to the purity of the SRC carcinoma component in clinical practice.