Comparative Study Of The Clinicopathological Characteristics And Prognosis Of Gastric Signet Ring Cell Carcinoma And Differently Differentiated Gastric Adenocarcinoma Based On SEER Database

Objective:Gastric signet ring cells(SRC)are a special pathological tissue type of gastric adenocarcinoma,and its clinicopathological characteristics and prognosis are worthy of our discussion.This study mainly analyzed and compared the pathological characteristics and survival prognosis of patients with gastric adenocarcinoma and gastric signet ring cell carcinoma with different degrees of differentiation(differentiated and undifferentiated).Methods:Screening patients with gastric adenocarcinoma from 2010 to 2015 from the Surveillance,Epidemiology,and End Results Database(SEER).Patients with multiple in situ tumors,distant metastases,preoperative adjuvant radiotherapy,and incomplete research data were excluded.According to the types of pathological tissues,it is divided into differentiated(well-differentiated and moderately differentiated)gastric cancer,SRC,and undifferentiated(poorly differentiated and undifferentiated)gastric cancer.The clinicopathological characteristics and survival prognosis differences between SRC and differently differentiated gastric cancer are comparatively studied.Results:Compared with non-SRC patients,SRC is more common in young(<60years),female,and white patients.Compared with the differentiated type,SRC is less common in EGC(23.60% VS 39.10%),lower N0(38.61% VS 61.03%),and larger tumor size >5 cm(31.15% VS 27.10%),and is less common in EGC(23.60% VS39.10%),and larger tumor size >5 cm(31.15% VS 27.10%).Type comparison is just the opposite.Among EGC patients,there was no significant difference in the prognosis of SRC patients.In AGC patients,the prognosis of SRC patients is related to age,race,tumor size,AJCC stage,T stage,and postoperative adjuvant treatment.Compared with non-SRC,patients with SRC have a better prognosis in EGC(HR0.626,95%CI 0.427-0.919,P<0.05),but poor prognosis in AGC(HR 1.139,95%CI1.030-1.258,P< 0.05).When comparing non-SRC into differentiated and undifferentiated type,it is found that in EGC,the prognosis of SRC is better than that of differentiated and undifferentiated type,while there is no significant difference between differentiated and undifferentiated type.In AGC,the prognosis of SRC and undifferentiated type is not significantly different,and both are worse than differentiated type.At the same time,the prognostic analysis of postoperative adjuvant therapy for SRC in AGC patients found that postoperative adjuvant radiotherapy or chemotherapy can significantly improve the survival rate of patients(34.6% and 36.2% VS 18.6%,P<0.05).Conclusion:SRC is a special type of pathological tissue in gastric adenocarcinoma,and its pathological characteristics and survival prognosis are significantly different from those of undifferentiated gastric adenocarcinoma.For the diagnosis and treatment of gastric signet ring cell carcinoma,early diagnosis and individualized and precise treatment should be adopted to improve the prognostic survival rate and quality of life of patients.