Endoscopic findings and clinicopathological characteristics of signet ring cell carcinoma of the stomach

Kim, Kwang Seok; Kim, Young Don; Han, Koon Hee; Lee, Se Hyung; Kim, Ji Hoon; Choi, Hye Young; Cheon, Gab Jin

Abstract

BACKGROUND: Signet ring cell carcinoma (SRCC) of the stomach has a young age prevalence and is associated with advanced gastric cancer (AGC) on diagnosis and a poor prognosis. However, the clinical and histopathological characteristics of the disease have been controversial and its endoscopic characteristics are not clear. Thus, we examined the clinical, endoscopic and histopathological characteristics of SRCC of the stomach and analyzed them in comparison with non-signet ring cell carcinoma (NSRCC).
METHODS
We retrospectively investigated the medical records of cases definitely diagnosed as stomach cancer by upper gastrointestinal endoscopy or radical gastrectomy from March 1996 to May 2006, and statistically analyzed the clinical, endoscopic and histopathological characteristics of the SRCC and NSRCC group selected at random.
RESULTS
During the study period, 1,840 patients were diagnosed as stomach cancer, and 117 (6.4%) of the patients were found to have SRCC. Clinically, the SRCC group showed a higher frequency in female (p=0.005), those aged below 60 years (p<0.001), non-smokers (p=0.031) and non-drinkers (p=0.045), and endoscopically the SRCC group was higher in the percentage of lesions located in the body part of stomach (p=0.003), the Helicobacter pylori (H. pylori) infection rate (p<0.001) and the Borrmann 4 type AGC (p=0.003). Significant independent characteristics of SRCC identified through multivariate analysis were an age below 60 years, H. pylori infection and a Borrmann 4 type AGC.
CONCLUSIONS
The endoscopic and clinicopathological characteristics of SRCC of the stomach are relatively young age on diagnosis, a high H. pylori infection rate, and a high percentage of Borrmann 4 type AGC.