J Cancer 2017; 8(17):3396-3404. doi:10.7150/jca.21017

Research Paper

Clinicopathological Characteristics and Prognostic Value of Signet Ring Cells in Gastric Carcinoma: A Meta-Analysis

Run-Cong Nie1#, Shu-Qiang Yuan1#, Yuan-Fang Li1#, Yong-Ming Chen1, Xiao-Jiang Chen1, Bao-Yan Zhu1, Li-Pu Xu1, Zhi-Wei Zhou1, Shi Chen2✉*, Ying-Bo Chen1✉*

1. Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;
2. Department of Gastric Surgery, The 6th Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
# These authors contributed equally to this study.
* These authors also contributed equally to this study.

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Nie RC, Yuan SQ, Li YF, Chen YM, Chen XJ, Zhu BY, Xu LP, Zhou ZW, Chen S, Chen YB. Clinicopathological Characteristics and Prognostic Value of Signet Ring Cells in Gastric Carcinoma: A Meta-Analysis. J Cancer 2017; 8(17):3396-3404. doi:10.7150/jca.21017. Available from http://www.jcancer.org/v08p3396.htm

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Background and Objectives: Previous studies of the prognostic value of the signet ring cell (SRC) type have yielded inconsistent results. Therefore, the aim of the present meta-analysis is to explore the clinicopathological characteristics and prognostic value of SRCs.

Methods: Relevant articles that compared SRC and non-SRC type in PubMed and Web of Science were comprehensively searched. Then, a meta-analysis was performed.

Results: A total of 19 studies including 35947 cases were analyzed. Compared with non-SRC patients, SRC patients tended to be younger (WMD: -3.88, P=0.001) and predominantly female (OR: 1.60, P<0.001). Additionally, SRC patients exhibited less upper third tumor location (OR: 0.62, P<0.001) and less frequent hematogenous metastasis (OR: 0.41, P<0.001). There was no difference in overall survival (OS) between SRC and non-SRC patients in the total population (HR: 1.02, P=0.830). Early gastric cancer with SRCs was associated with better OS (HR: 0.57, P=0.002), while advanced gastric cancer with non-SRCs was associated with a worse prognosis (HR: 1.17, P<0.001).

Conclusions: This meta-analysis revealed that SRC tends to affect young females and tends to be located in the middle and lower third of the stomach. Early SRCs are associated with better prognoses, while advanced SRCs are associated with worse prognoses.

Keywords: signet ring cell, gastric cancer, prognosis, survival.