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 OS (HR: 1.12, 95%CI: 1.01–1.23, P = 0.034; I² = 85.1%) and 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 when excluding stage IV patients (HR: 1.18, 95%CI: 1.07–1.29, P < 0.001; I² = 6.5%). 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.

中文翻译：

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图灵环细胞组织学对早期和晚期胃癌患者的不同预后意义：系统评价和荟萃分析。

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数据库进行系统的文献检索。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

这项荟萃分析共纳入21项研究。SRC组织学的患病率从8.7％到50％不等。SRC组织学类型与较差的OS（HR：1.12，95％CI：1.01–1.23，P = 0.034; I ²  = 85.1％）和DFS（HR：1.17，95％CI：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比非SRC类型的OS好（HR：0.60，95％CI：0.48-0.75，P <0.001； I ²  = 33.7％）。然而，当排除IV期患者时，它是晚期GC的不良预后因素（HR：1.18，95％CI：1.07-1.29，P <0.001； I ²  = 6.5％）。与非SRC型相比，SRC型具有更高的腹膜复发风险（OR：1.36，95％CI：1.06-1.75，P = 0.017； I ²  = 1.3％）。

结论

对于早期和晚期GC患者，SRC类型具有明显不同的预后意义。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。