Introduction: Patients with very early-stage gastric signet ring cell carcinoma (SRC) are eligible for minimally invasive treatment, like endoscopic submucosal dissection. However, population-based data on regional lymph node metastasis (LNM) and distant metastasis of gastric SRC are lacking. This study aimed to identify the prevalence of LNM and distant metastasis in mucosal cancer (T1a) of gastric SRC. Methods: The Collaborative Stage Data Survey was performed by the Korean Center of Cancer Registry between 2010 and 2015 to establish collaborative stage data of the stomach, colon, rectum, rectosigmoid junction, and breast. From the survey data, information on patients with gastric SRC was extracted for analysis. Variables including age, sex, diagnosis date, primary site, tumor size, histology, American Joint Committee on Cancer staging system scores, and Surveillance, Epidemiology, and End Results summary stage were analyzed. Results: A total of 1,335 (65.7%) patients had mucosal gastric SRC, and 1,189 (89.1%) patients had surgery and 134 (10%) had endoscopic treatment. Of them, 1,283 (96.1%) patients did not have regional LNM, and 52 (3.9%) patients had regional LNM and 6 (0.4%) had distant metastasis. The hazard ratios of LNM and distant metastasis were 14.98 (95% CI: 4.18–53.2) and 10.09 (95% CI: 2.30–44.17). Conclusions: Reginal LNM and distant metastasis occur very less in mucosal gastric SRC, but they are associated with an increased risk of cancer-related death. Even in early stage, surgery should be considered as a standard treatment of mucosal gastric SRC.
Dig Surg

中文翻译：

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粘膜胃印戒细胞癌区域淋巴结转移的患病率：韩国中央癌症登记处协作阶段数据调查的分析

简介：极早期胃印戒细胞癌 (SRC) 患者有资格接受微创治疗，如内窥镜黏膜下剥离术。然而，缺乏基于人群的区域淋巴结转移（LNM）和胃 SRC 远处转移的数据。本研究旨在确定胃 SRC 黏膜癌 (T1a) 中 LNM 的患病率和远处转移。方法：协作阶段数据调查由韩国癌症登记中心在 2010 年至 2015 年间进行，以建立胃、结肠、直肠、直肠乙状结肠交界处和乳房的协作阶段数据。从调查数据中提取胃SRC患者的信息进行分析。分析了包括年龄、性别、诊断日期、原发部位、肿瘤大小、组织学、美国癌症联合委员会分期系统评分以及监测、流行病学和最终结果总结阶段在内的变量。结果：共有 1,335 例（65.7%）患者发生胃黏膜 SRC，1,189 例（89.1%）患者接受了手术，134 例（10%）患者接受了内镜治疗。其中，1283 例（96.1%）患者无局部 LNM，52 例（3.9%）患者有局部 LNM，6 例（0.4%）有远处转移。LNM 和远处转移的风险比分别为 14.98（95% CI：4.18-53.2）和 10.09（95% CI：2.30-44.17）。结论：胃黏膜 SRC 中区域 LNM 和远处转移的发生率非常低，但它们与癌症相关死亡风险增加有关。即使在早期，手术也应被视为胃黏膜 SRC 的标准治疗方法。
挖掘外科