Histologic purity of signet ring cell carcinoma is a favorable risk factor for lymph node metastasis in poorly cohesive, submucosa-invasive ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-09-23

AUTHORS

Yon Hee Kim, Ji Hye Park, Cheol Keun Park, Jie-Hyun Kim, Sang Kil Lee, Yong Chan Lee, Sung Hoon Noh, Hyunki Kim

ABSTRACT

BackgroundThe prediction of biologic behavior of poorly cohesive early gastric carcinoma (EGC) is an important issue in the selection of the treatment modality. To elucidate the risk factors for lymph node metastasis (LNM) of poorly cohesive EGC, we focused on the histologic purity of the poorly cohesive component and evaluated the impact of this factor on LNM.MethodsWe divided poorly cohesive EGC into (1) pure signet ring cell (SRC) carcinoma, which was defined as composed only of signet ring cells or poorly cohesive cells and (2) mixed SRC carcinoma, defined as poorly cohesive carcinoma with minor tubular components. We reviewed the clinicopathologic features, including age, sex, location, size, depth, lymphovascular invasion (LVI), LNM, ulceration, and intestinal metaplasia between the two groups in a large series of poorly cohesive, submucosa-invasive EGC (n = 317).ResultsLNM was found in 58 cases (18.3 %). Mixed SRC carcinoma histologic type (p < 0.001), larger tumor size (more than 2 cm) (p = 0.012), and the presence of LVI (p < 0.001) were associated with LNM. Pure SRC carcinomas accounted for 56.2 % (178/317) of the cases. Fourteen pure SRC carcinomas (7.8 %) showed LNM, whereas 44 mixed SRC carcinomas (31.9 %) exhibited LNM (p < 0.001). On multivariate logistic regression, the presence of LVI (odds ratio 6.737; 95 % confidence interval 2.714–16.720; p < 0.001) and mixed SRC carcinoma histologic type (odds ratio 4.674; 95 % confidence interval 2.370–9.216; p < 0.001) were independent predictors of LNM in poorly cohesive, submucosa-invasive EGC.ConclusionsThe presence of a tubular component in SRC carcinoma was a risk factor for LNM in poorly cohesive, submucosa-invasive EGC. On the basis of this finding, we propose that the presence of a minor tubular component or the purity of the poorly cohesive/SRC carcinoma component should be reported in daily pathologic practice. More... »

PAGES

583-590

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10120-016-0645-x

DOI

http://dx.doi.org/10.1007/s10120-016-0645-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051057673

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27663439


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51 cell carcinoma
52 cells
53 clinicopathologic features
54 cohesive EGC
55 cohesive carcinoma
56 cohesive cells
57 cohesive component
58 components
59 daily pathologic practice
60 depth
61 early gastric carcinoma
62 factors
63 favorable risk factors
64 features
65 findings
66 gastric carcinoma
67 group
68 histologic purity
69 histologic type
70 impact
71 important issue
72 independent predictors
73 intestinal metaplasia
74 invasion
75 issues
76 large series
77 larger tumor size
78 location
79 logistic regression
80 lymph node metastasis
81 lymphovascular invasion
82 metaplasia
83 metastasis
84 minor tubular component
85 mixed SRC carcinoma
86 modalities
87 multivariate logistic regression
88 node metastasis
89 pathologic practice
90 practice
91 prediction
92 predictors
93 presence
94 presence of LVI
95 pure signet ring cell carcinoma
96 purity
97 regression
98 ring cell (SRC) carcinoma
99 ring cells
100 risk factors
101 selection
102 series
103 sex
104 signet ring cell carcinoma
105 signet ring cells
106 size
107 submucosa-invasive EGC
108 treatment modalities
109 tubular components
110 tumor size
111 types
112 ulceration
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