Research progress on pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Lingying ,  LU Chunyan

Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LU Chunyan, Email: luchunyan@wchscu.cn

Keywords：

Gastric signet ring cell carcinoma; classification; metastasis; prognosis; tomography/X-ray comput

DOI：

10.7507/1007-9424.202201003

Video：

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Objective To summarize the pathological, clinical features and research progress of CT diagnosis of signet ring cell carcinoma of the stomach, in order to help further understanding and early clinical diagnosis and treatment of this disease. Method The literatures related to pathological classification, clinical manifestations, metastasis patterns, prognosis and CT features of gastric signet ring cell carcinoma were searched and reviewed. Results Gastric signet ring cell carcinoma often had no special clinical symptoms and signs in the early stage, and often entered the advanced stage when symptoms such as gastric ulcer appeared. Gastric signet ring cell carcinoma is more prone to peritoneal and ascites metastases than other types of gastric cancer. The more specific metastases include diffuse infiltration along the bile duct and portal vein to the hepatic hilar area and extension to the Glisson sheath. Compared with other types of gastric cancer, there is no prognostic advantage. even worse. CT showed that the lesions were mostly located in the middle and lower 1/3 of the stomach, with a diffuse infiltrating gross appearance, obvious thickening and enhancement of the gastric wall, and delayed enhancement, especially in the low-enhanced area. The emerging dual-energy/spectral CT has shown good application prospects for the diagnosis of gastric cancer. Conclusions The pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma have certain characteristics, but there are still many controversies, which are related to the fact that some pathological characteristics or infiltration patterns of gastric signet ring cell carcinoma itself have not been clearly studied, which will be discussed in the future direction of continuing research.

Citation： CHEN Lingying, LU Chunyan. Research progress on pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(3): 376-381. doi: 10.7507/1007-9424.202201003 Copy

1.	王震, 赵春临, 孙阳, 等. 基于SEER数据库的胃印戒细胞癌临床病理特征及预后分析. 医学研究生学报, 2019, 32(12): 1301-1307.
2.	Lee JH, Park MS, Kim KW, et al. Advanced gastric carcinoma with signet ring cell carcinoma versus non-signet ring cell carcinoma: differentiation with multidetector CT. J Comput Assist Tomogr, 2006, 30(6): 880-884.
3.	张召珍, 沈俊, 陈洁. 胃印戒细胞癌的内镜及临床特点. 中华消化内镜杂志, 2007, 24(4): 284-286.
4.	Kwon KJ, Shim KN, Song EM, et al. Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach. Gastric Cancer, 2014, 17(1): 43-53.
5.	Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of signet ring gastric cancer. J Clin Oncol, 2012, 30(28): 3493-3498.
6.	黄海波, 江生. CT辅助诊断胃癌应用进展. 医学综述, 2014, 20(11): 2044-2057.
7.	聂爱英, 梁丽娟, 雷超, 等. 胃印戒细胞癌临床病理特点的分析. 现代肿瘤医学, 2017, 25(6): 0914-0917.
8.	徐仲航, 金殷植, 房学东. 胃印戒细胞癌的研究进展. 中华胃肠外科杂志, 2018, 21(10): 1196-1200.
9.	杨琳, 王艳萍, 吴东瑛, 等. 胃印戒细胞癌与黏液腺癌生物学特征及分子病理学机制的比较研究. 世界华人消化杂志, 2002, 10(5): 516-524.
10.	唐磊. 胃癌术后复发、转移的影像学诊断. 中国实用外科杂志, 2015, 35(10): 1132-1144.
11.	李琦, 朱正纲. 胃癌术后腹膜复发和转移的早期诊断(文献综述). 国外医学(外科学分册), 2003, 30(2): 73-76.
12.	崔景利, 梁寒, 邓靖宇, 等. 胃印戒细胞癌的临床病理特点和预后分析. 中华肿瘤杂志, 2015, 37(5): 367-370.
13.	Rijken A, Lurvink RJ, Luyer MDP, et al. The burden of peritoneal metastases from gastric cancer: a systematic review on the incidence, Risk Factors and Survival. J Clin Med, 2021, 10(21): 4882. doi: 10.3390/jcm10214882.
14.	张培谊, 邹赛英, 唐新萍. 胃印戒细胞癌腹水转移的超微结构特征. 电子显微学报, 2004, 23(4): 325-325.
15.	Wang Z, Zhang X, Hu J, et al. Predictive factors for lymph node metastasis in early gastric cancer with signet ring cell histology and their impact on the surgical strategy: analysis of single institutional experience. J Surg Res, 2014, 191(1): 130-133.
16.	张文静, 吴克俭, 谭宁平. 早期胃癌淋巴结转移的危险因素及预后分析. 中国中西医结合消化杂志, 2020, 28(5): 331-337.
17.	章志伟, 陈如意, 蒋林华, 等. 早期远端胃印戒细胞癌淋巴结转移的危险因素分析及外科手术指征探讨. 中国普外基础与临床杂志, 2020, 27(3): 315-319.
18.	Jin X, Wu W, Zhao J, et al. Clinical features and risk factors for lymph node metastasis in early signet ring cell gastric cancer. Front Oncol, 2021, 11: 630675. doi: 10.3389/fonc.2021.630675.
19.	张佩范, 袁媛, 吴烨秋. 残胃癌与残胃再发癌病理分析. 中国实用外科杂志, 1987, 7(2): 212-214.
20.	郗洪庆, 李佶阳, 李少卿, 等. 胃癌根治术后残胃癌与胃癌复发的临床病理学特征比较及预后分析. 中华胃肠外科杂志, 2018, 21(5): 212-213.
21.	张荫昌, 张佩范, 陈峻青, 等 60例胃癌的形态学及生物学特性的研究. 中华病理学杂志, 1964, 8(4): 243-247.
22.	Lee HH, Song KY, Park CH, et al. Undifferentiated-type gastric adenocarcinoma: prognostic impact of three histological types. World J Surg Oncol, 2012, 10: 254. doi: 10.1186/1477- 7819-10-254.
23.	Hyung WJ, Noh SH, Lee JH, et al. Early gastric carcinoma with signet ring cell histology. B Cancer, 2002, 94(1): 78-83.
24.	Zhao S, Lv L, Zheng K, et al. Prognosis and biological behavior of gastric signet-ring cell carcinoma better or worse: a meta-analysis. Front Oncol, 2021, 11: 603070. doi: 10.3389/fonc.2021.603070.
25.	Ha TK, An JY, Youn HK, et al. Indication for endoscopic mucosal resection in early signet ring cell gastric cancer. Ann Surg Oncol, 2008, 15(2): 508-513.
26.	石晓燕, 王润洁, 刘超英. 胃印戒细胞癌临床病理特征研究. 肿瘤防治研究, 2012, 39(7): 826-828.
27.	Li C, Kim S, Lai JF, et al. Advanced gastric carcinoma with signet ring cell histology. Oncology, 2007, 72(1-2): 64-68.
28.	Piessen G, Messager M, Leteurtre E, et al. Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg, 2009, 250(6): 878-887.
29.	赵刚, 詹文华, 彭俊生, 等. 进展期胃印戒细胞癌患者的临床病理特点与预后. 中华普通外科杂志, 2006, 21(4): 251-253.
30.	Liu K, Wan J, Bei Y, et al. Prognostic impact of different histological types on gastric adenocarcinoma: a surveillance, epidemiology, and end results database analysis. Pathol Oncol Res, 2017, 23(4): 881-887.
31.	Zhang C, Liu R, Zhang WH, et al. Difference between signet ring cell gastric cancers and non-signet ring cell gastric cancers: a systematic review and meta-analysis. Front Oncol, 2021, 11: 618477. doi: 10.3389/fonc.2021.618477.
32.	詹文华. 增强胃印戒细胞癌特征及其诊治要点的意识. 消化肿瘤杂志(电子版), 2013, 5(1): 5-7.
33.	周金金, 关文华, 强军, 等. 胃印戒细胞癌的增强CT诊断与鉴别诊断. 临床放射学杂志, 2018, 37(6): 972-975.
34.	Park MS, Yu JS, Kim MJ, et al. Mucinous versus nonmucinous gastric carcinoma: differentiation with helical CT. Radiology, 2002, 223(2): 540-546.
35.	邹茹欣, 周洋, 巴志昌, 等. 进展期胃癌64排螺旋CT三期增强影像强化特点与组织学分型相关性的研究. 实用肿瘤学杂志, 2013, 27(6): 549-553.
36.	Chen J, Cai R, Ren G, et al. Differences in clinicopathological characteristics and computed tomography findings between signet ring cell carcinoma and nonsignet ring cell carcinoma in early and advanced gastric cancer. Cancer Med, 2018, 7(4): 1160-1169.
37.	朱建兵, 陈光强, 李勇, 等. 胃印戒细胞癌的多排螺旋CT强化模式及分期初步研究. 实用放射学杂志, 2013, 29(7): 1094-1097.
38.	朱建兵, 陈光强, 李勇, 等. 64排螺旋CT对胃印戒细胞癌淋巴结转移的诊断价值. 航空航天医学杂志, 2012, 23(2): 129-130.
39.	沈丹萍. 胃印戒细胞癌的增强CT诊断与鉴别诊断. 养生保健指南, 2020, 37: 269.
40.	邹赛英, 唐新萍, 张培谊. 胃印戒细胞癌血管形成及超微结构特征与浸润转移的关系. 电子显微学报, 2002, 21(6): 900-902.
41.	乔英, 李健丁, 张瑞平, 等. CT三期增强扫描对胃癌淋巴结转移的诊断价值. 放射学实践, 2006, 21(5): 507-510.
42.	孙国鹏. CT能谱成像在术前评估胃癌患者病理类型的临床价值. 中国现代药物应用, 2020, 14(6): 54-56.
43.	董杰, 刘松, 潘梁, 等. CT能谱成像定量评估胃癌分化程度的应用价值. 东南大学学报(医学版), 2018, 37(3): 489-493.
44.	Pan Z, Pang L, Ding B, et al. Gastric cancer staging with dual energy spectral CT imaging. PLoS One, 2013, 8(2): e53651. doi: 10.1371/journal.pone.0053651.

1. 王震, 赵春临, 孙阳, 等. 基于SEER数据库的胃印戒细胞癌临床病理特征及预后分析. 医学研究生学报, 2019, 32(12): 1301-1307.
2. Lee JH, Park MS, Kim KW, et al. Advanced gastric carcinoma with signet ring cell carcinoma versus non-signet ring cell carcinoma: differentiation with multidetector CT. J Comput Assist Tomogr, 2006, 30(6): 880-884.
3. 张召珍, 沈俊, 陈洁. 胃印戒细胞癌的内镜及临床特点. 中华消化内镜杂志, 2007, 24(4): 284-286.
4. Kwon KJ, Shim KN, Song EM, et al. Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach. Gastric Cancer, 2014, 17(1): 43-53.
5. Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of signet ring gastric cancer. J Clin Oncol, 2012, 30(28): 3493-3498.
6. 黄海波, 江生. CT辅助诊断胃癌应用进展. 医学综述, 2014, 20(11): 2044-2057.
7. 聂爱英, 梁丽娟, 雷超, 等. 胃印戒细胞癌临床病理特点的分析. 现代肿瘤医学, 2017, 25(6): 0914-0917.
8. 徐仲航, 金殷植, 房学东. 胃印戒细胞癌的研究进展. 中华胃肠外科杂志, 2018, 21(10): 1196-1200.
9. 杨琳, 王艳萍, 吴东瑛, 等. 胃印戒细胞癌与黏液腺癌生物学特征及分子病理学机制的比较研究. 世界华人消化杂志, 2002, 10(5): 516-524.
10. 唐磊. 胃癌术后复发、转移的影像学诊断. 中国实用外科杂志, 2015, 35(10): 1132-1144.
11. 李琦, 朱正纲. 胃癌术后腹膜复发和转移的早期诊断(文献综述). 国外医学(外科学分册), 2003, 30(2): 73-76.
12. 崔景利, 梁寒, 邓靖宇, 等. 胃印戒细胞癌的临床病理特点和预后分析. 中华肿瘤杂志, 2015, 37(5): 367-370.
13. Rijken A, Lurvink RJ, Luyer MDP, et al. The burden of peritoneal metastases from gastric cancer: a systematic review on the incidence, Risk Factors and Survival. J Clin Med, 2021, 10(21): 4882. doi: 10.3390/jcm10214882.
14. 张培谊, 邹赛英, 唐新萍. 胃印戒细胞癌腹水转移的超微结构特征. 电子显微学报, 2004, 23(4): 325-325.
15. Wang Z, Zhang X, Hu J, et al. Predictive factors for lymph node metastasis in early gastric cancer with signet ring cell histology and their impact on the surgical strategy: analysis of single institutional experience. J Surg Res, 2014, 191(1): 130-133.
16. 张文静, 吴克俭, 谭宁平. 早期胃癌淋巴结转移的危险因素及预后分析. 中国中西医结合消化杂志, 2020, 28(5): 331-337.
17. 章志伟, 陈如意, 蒋林华, 等. 早期远端胃印戒细胞癌淋巴结转移的危险因素分析及外科手术指征探讨. 中国普外基础与临床杂志, 2020, 27(3): 315-319.
18. Jin X, Wu W, Zhao J, et al. Clinical features and risk factors for lymph node metastasis in early signet ring cell gastric cancer. Front Oncol, 2021, 11: 630675. doi: 10.3389/fonc.2021.630675.
19. 张佩范, 袁媛, 吴烨秋. 残胃癌与残胃再发癌病理分析. 中国实用外科杂志, 1987, 7(2): 212-214.
20. 郗洪庆, 李佶阳, 李少卿, 等. 胃癌根治术后残胃癌与胃癌复发的临床病理学特征比较及预后分析. 中华胃肠外科杂志, 2018, 21(5): 212-213.
21. 张荫昌, 张佩范, 陈峻青, 等 60例胃癌的形态学及生物学特性的研究. 中华病理学杂志, 1964, 8(4): 243-247.
22. Lee HH, Song KY, Park CH, et al. Undifferentiated-type gastric adenocarcinoma: prognostic impact of three histological types. World J Surg Oncol, 2012, 10: 254. doi: 10.1186/1477- 7819-10-254.
23. Hyung WJ, Noh SH, Lee JH, et al. Early gastric carcinoma with signet ring cell histology. B Cancer, 2002, 94(1): 78-83.
24. Zhao S, Lv L, Zheng K, et al. Prognosis and biological behavior of gastric signet-ring cell carcinoma better or worse: a meta-analysis. Front Oncol, 2021, 11: 603070. doi: 10.3389/fonc.2021.603070.
25. Ha TK, An JY, Youn HK, et al. Indication for endoscopic mucosal resection in early signet ring cell gastric cancer. Ann Surg Oncol, 2008, 15(2): 508-513.
26. 石晓燕, 王润洁, 刘超英. 胃印戒细胞癌临床病理特征研究. 肿瘤防治研究, 2012, 39(7): 826-828.
27. Li C, Kim S, Lai JF, et al. Advanced gastric carcinoma with signet ring cell histology. Oncology, 2007, 72(1-2): 64-68.
28. Piessen G, Messager M, Leteurtre E, et al. Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg, 2009, 250(6): 878-887.
29. 赵刚, 詹文华, 彭俊生, 等. 进展期胃印戒细胞癌患者的临床病理特点与预后. 中华普通外科杂志, 2006, 21(4): 251-253.
30. Liu K, Wan J, Bei Y, et al. Prognostic impact of different histological types on gastric adenocarcinoma: a surveillance, epidemiology, and end results database analysis. Pathol Oncol Res, 2017, 23(4): 881-887.
31. Zhang C, Liu R, Zhang WH, et al. Difference between signet ring cell gastric cancers and non-signet ring cell gastric cancers: a systematic review and meta-analysis. Front Oncol, 2021, 11: 618477. doi: 10.3389/fonc.2021.618477.
32. 詹文华. 增强胃印戒细胞癌特征及其诊治要点的意识. 消化肿瘤杂志(电子版), 2013, 5(1): 5-7.
33. 周金金, 关文华, 强军, 等. 胃印戒细胞癌的增强CT诊断与鉴别诊断. 临床放射学杂志, 2018, 37(6): 972-975.
34. Park MS, Yu JS, Kim MJ, et al. Mucinous versus nonmucinous gastric carcinoma: differentiation with helical CT. Radiology, 2002, 223(2): 540-546.
35. 邹茹欣, 周洋, 巴志昌, 等. 进展期胃癌64排螺旋CT三期增强影像强化特点与组织学分型相关性的研究. 实用肿瘤学杂志, 2013, 27(6): 549-553.
36. Chen J, Cai R, Ren G, et al. Differences in clinicopathological characteristics and computed tomography findings between signet ring cell carcinoma and nonsignet ring cell carcinoma in early and advanced gastric cancer. Cancer Med, 2018, 7(4): 1160-1169.
37. 朱建兵, 陈光强, 李勇, 等. 胃印戒细胞癌的多排螺旋CT强化模式及分期初步研究. 实用放射学杂志, 2013, 29(7): 1094-1097.
38. 朱建兵, 陈光强, 李勇, 等. 64排螺旋CT对胃印戒细胞癌淋巴结转移的诊断价值. 航空航天医学杂志, 2012, 23(2): 129-130.
39. 沈丹萍. 胃印戒细胞癌的增强CT诊断与鉴别诊断. 养生保健指南, 2020, 37: 269.
40. 邹赛英, 唐新萍, 张培谊. 胃印戒细胞癌血管形成及超微结构特征与浸润转移的关系. 电子显微学报, 2002, 21(6): 900-902.
41. 乔英, 李健丁, 张瑞平, 等. CT三期增强扫描对胃癌淋巴结转移的诊断价值. 放射学实践, 2006, 21(5): 507-510.
42. 孙国鹏. CT能谱成像在术前评估胃癌患者病理类型的临床价值. 中国现代药物应用, 2020, 14(6): 54-56.
43. 董杰, 刘松, 潘梁, 等. CT能谱成像定量评估胃癌分化程度的应用价值. 东南大学学报(医学版), 2018, 37(3): 489-493.
44. Pan Z, Pang L, Ding B, et al. Gastric cancer staging with dual energy spectral CT imaging. PLoS One, 2013, 8(2): e53651. doi: 10.1371/journal.pone.0053651.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress on pathological clinical features and CT diagnosis of gastric signet ring cell carcinoma

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