Objective: To review relevant studies and perform a meta-analysis to evaluate the prognostic significance of signet ring cell(SRC) histology for gastric cancer(GC) patients.

Methods: Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted and the association between SRC histology and survival outcome were evaluated using a fixed-effect or random-effect model.

Results: A total of 21 studies were included in this meta-analysis. The prevalence of SRC histology varied from 8.7% to 50%. SRC histology type was associated with poorer survival outcome in GC patients, regardless of OS(HR:1.12, 95%CI:1.01-1.23, P=0.034; I²=85.1%) or DFS(HR:1.17, 95%CI:1.00-1.37, P=0.040; I²=63.6%). The subgroup analysis indicated that SRC type had a better OS than non-SRC type for early GC patients(HR:0.60, 95%CI:0.48-0.75, P<0.001; I²=33.7%). However, it was a poor prognostic factor for advanced GC patients when excluding stage IV patients(HR:1.18, 95%CI:1.07-1.29, P<0.001; I²=6.5%). In terms of tumor recurrence, patients with SRC type had a higher risk of peritoneal recurrence than non-SRC type(OR:1.36, 95%CI:1.06-1.75, P=0.017; I²=1.3%).

Conclusion: SRC type had a distinctly different prognostic significance for early and advanced GC patients. SRC type was associated with better survival outcomes in early GC patients, but it was a predictive factor for poor survival in advanced GC patients.

目的：回顾相关研究并进行荟萃分析，以评估印戒细胞（SRC）组织学对胃癌（GC）患者的预后意义。

方法：使用PubMed和Embase数据库进行系统文献检索。提取相关数据，并使用固定效应或随机效应模型评估SRC组织学与生存结果之间的关联。

结果：本荟萃分析共纳入21项研究。SRC组织学的患病率从8.7％到50％不等。无论OS（HR：1.12，95％CI：1.01-1.23，P = 0.034; I ² = 85.1％）或DFS（HR：1.17，95％CI :)，SRC组织学类型与GC患者较差的生存结果相关。1.00-1.37，P ＝ 0.040； I ²＝ 63.6％）。亚组分析表明，对于早期GC患者，SRC类型的OS优于非SRC类型（HR：0.60，95％CI：0.48-0.75，P <0.001； I ² = 33.7％）。但是，排除IV期患者后，这是晚期GC患者的不良预后因素（HR：1.18，95％CI：1.07-1.29，P <0.001； I ²= 6.5％）。就肿瘤复发而言，SRC型患者的腹膜复发风险高于非SRC型患者（OR：1.36，95％CI：1.06-1.75，P = 0.017； I ² = 1.3％）。

结论：SRC类型对早期和晚期GC患者的预后意义明显不同。SRC类型与早期GC患者的较好生存结果相关，但它是晚期GC患者生存不良的预测因素。