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Objective To explore the clinicopathological characteristics, prognosis and influencing factors of different pathological subtypes of gastric signet ring cell carcinoma (GSRC). Methods A retrospective analysis was performed on the clinical data of 232 patients with GSRC collected from January 2016 to December 2018 in Lanzhou University Second Hospital. According to the WHO classification criteria for GSRC, the patients were divided into pure gastric signet-ring cell carcinoma (pGSRC, n=36) and mixed gastric signet-ring cell carcinoma (mGSRC, n=196). The follow-up as of September 30, 2022, the survival analysis was done using Kaplan-Meier method, the univariate and multivariate Cox regression were performed to analyze the risk factors affecting the prognosis of GSRC patients. Results The median survival time of pGSRC and mGSRC patients was 41.0(6.0-70.0) months and 24.0(2.0-74.0) months, respectively. Kaplan-Meier analysis showed that combination with diabetes, anemia, tumor diameter, nerve invasion, lymphovascular invasion, T stage, N stage, GSRC pathological subtype, CA125 and tumor diameter could affect the overall survival (OS) of patients with GSRC after radical gastrectomy (P<0.05), but Her-2, whether adjuvant chemotherapy or not and others elements had no significant effect on OS of GSRC patients after radical gastrectomy (P>0.05). Univariate Cox regression analysis showed that the combination with diabetes (P=0.031), anemia (P=0.028), tumor diameter >5 cm (P=0.009), nerve invasion (P=0.002), lymphovascular invasion (P=0.002), mGSRC pathological type (P=0.039), T2-T4 stage (P=0.001), N1-N4 stage (P=0.004), pTNM stage Ⅲ (P=0.044), the number of lymph node metastasis >30 (P=0.044) and CA125 positive (P=0.009) were related to the prognosis of patients with GSRC after radical gastrectomy. Multivariate Cox regression analysis showed that mGSRC pathological type (P=0.035), T2-T4 stage (P=0.003), CA125 positive (P=0.010) were independent risk factors for poor prognosis of patients with GSRC after radical gastrectomy. Conclusion Compared with pGSRC, patients with mGSRC at diagnosis have higher pTNM stages, more aggressive, and shorter median survival time. mGSRC pathological type, T2-T4 stage, and CA125 positive were all independent factors affecting the prognosis of patients with GSRC.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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