Clinical implication of FDG-PET in advanced gastric cancer with signet ring cell histology

2011 ◽  
Vol 104 (6) ◽  
pp. 566-570 ◽  
Author(s):  
Kyung Ho Pak ◽  
Mijin Yun ◽  
Jae-Ho Cheong ◽  
Woo Jin Hyung ◽  
Seung Ho Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Fdg Pet ◽  
Clinical Implication ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

Comparison of 68Ga-FAPI-04 and 18F-FDG for the Detection of Primary Gastric Cancers and Metastasis 

2021 ◽  
Author(s):  
Donglang Jiang ◽  
Xing Chen ◽  
Zhiwen You ◽  
Hao Wang ◽  
Xiaoyun Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Cancer Diagnosis ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Gastric Cancers ◽  
Signet Ring ◽  
Ring Cell

Abstract Introduction Early and precise diagnosis and staging of gastric cancer are important for its treatment and management. However, the low sensitivity of 18F-fluorodeoxyglucose (18F-FDG) for gastric cancer diagnosis limits its application. Currently, the tracer 68Ga-FAPI, which targets fibroblast activation protein (FAP), is widely used to diagnose various cancers. However, the diagnostic value of 68Ga-FAPI in gastric cancer is still unclear. In this study, we aimed to investigate the potential advantage of 68Ga-FAPI-04 over 18F-FDG in the evaluation of gastric cancer.Methods: Thirty-eight patients with gastric cancer (31 with adenocarcinoma and 7 with signet ring cell carcinoma) were recruited for this study. All of the participants underwent 68Ga-FAPI-04 and 18F-FDG imaging by positron emission tomography (PET)/computed tomography (CT) or PET/magnetic resonance (MR). The results were interpreted by two experienced nuclear medicine physicians, and the maximum standardized uptake value (SUVmax) was calculated.Results: For the detection of primary gastric cancer, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET were 100% (38/38) and 81.6% (31/38), respectively. Four cases of adenocarcinoma and three cases of signet ring cell carcinoma were missed by 18F-FDG PET. The SUVmax of 68Ga-FAPI-04 in tumors greater than 4 cm (11.0 ± 4.5) was higher than tumors less than 4 cm (4.5 ± 3.2) (P = 0.0015). The SUVmax of 68Ga-FAPI-04 was higher in T2-4 tumors (9.7 ± 4.4) than in T1 tumors (3.1 ± 1.5) (P = 0.0002). For the detection of metastatic lesions, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET in 10 patients with regional lymph node metastasis and distant metastasis were 6/10 and 5/10, respectively.Conclusion: Compared to 18F-FDG PET, 68Ga-FAPI-04 PET had superior potential in detecting primary gastric cancers and metastatic lymph nodes, 68Ga-FAPI-04 PET also had a better performance on small gastric cancer detection. 68Ga-FAPI-04 PET could provide better performance for gastric cancer diagnosis and staging.

Apatinib in the treatment of non-operable or advanced gastric cancer: Evidence of efficacy and safety in a real-world study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15515-e15515
Author(s):  
Ligang Xing ◽  
Wei Cao ◽  
Gang Cui ◽  
Huanhu Zhang ◽  
Yiran Shi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Advanced Gastric Cancer ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Combined Chemotherapy ◽  
Efficacy And Safety ◽  
Signet Ring ◽  
Organ Metastasis ◽  
Ring Cell

e15515 Background: Apatinib, a small molecule tyrosine kinase inhibitor, has been approved to use in patients with advanced gastric adenocarcinoma or gastroesophageal junction adenocarcinoma after at least two systemic chemotherapy regimens in China. This study aims to observe the efficacy and safety of apatinib in real word clinical practice and preliminarily explore the characteristics of population with more clinical benefit. Methods: This study included patients with non-operative or advanced gastric cancer confirmed by histopathology or cytology, and did not intervene the regimen which was entirely determined by the clinicians and patients. Results: From April 16, 2018 to January 12, 2019, 732 patients enrolled, and all patients had been followed up at least once. Total 342 patients were eligible for efficacy evaluation. Among them, 43 patients achieved partial response (PR), 209 patients achieved stable disease (SD) and 90 patients experienced progression disease (PD). The overall response rate (ORR) was 12.55%, and the disease control rate was 73.6%. The mPFS have not yet reached. For patients ≥65 years, the ORR was 26.32%, and for patients < 65 years, ORR was 8.33%. For patients with non-signet ring cell carcinoma and signet ring cell carcinoma, the ORRs were 15.22% and 6.0%. For patients with and without organ metastasis, the ORRs were 15.25% and 3.75% respectively. The PFS analysis showed that, Combined chemotherapy and age > 65 may predict longer PFS. The OS analysis showed that, ECOG 0-1, combined chemotherapy, AFP positive and male predict longer OS. The overall incidence of adverse events was 84%. The most common adverse events were hypertension (28.8%), fatigue (22.4%), hand-foot syndrome (17.3%), anorexia (12.8%) and nausea (10.5%). Conclusions: Apatinib showed promising antitumor activity in patients with non- operable or advanced Gastric Cancer in this real word study. The prolonging survival benefits maybe could be attenuated by age <65, without organ metastasis, ECOG score >1, treatment regimen, normal AFP, and pathological diagnosis of non-signet ring cell carcinoma. Clinical trial information: ChiCTR1800015701.

scholarly journals Clinicopathological differences in signet ring cell adenocarcinoma between early and advanced gastric cancer

2018 ◽  
Vol 22 (2) ◽  
pp. 255-263 ◽  
Author(s):  
Yi-Chu Kao ◽  
Wen-Liang Fang ◽  
Ruei-Fang Wang ◽  
Anna Fen-Yau Li ◽  
Muh-Hwa Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Signet Ring Cell ◽  
Signet Ring Cell Adenocarcinoma ◽  
Signet Ring ◽  
Ring Cell

Capcitabine and oxaliplatin (XELOX) in the treatment of advanced gastric cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14089-14089
Author(s):  
R. Quek ◽  
W. T. Lim ◽  
K. F. Foo ◽  
W. H. Koo ◽  
H. C. Toh
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Overall Response Rate ◽  
Venous Catheter ◽  
Toxicity Assessment ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Measurable Disease ◽  
Ring Cell ◽  
Grade 3

14089 Background: Effective 1st line chemotherapy that is easily delivered and tolerable is important in patients with advanced gastric cancer (AGC). This study aimed to evaluate the toxicity and efficacy of combination capecitabine and oxaliplatin (XELOX), given 3 weekly, in patients with AGC. Methods: Twenty-seven patients with AGC, were treated with XELOX at the National Cancer Centre Singapore between June 2003 and December 2005. Capecitabine was given 2000 mg/m2/day, days 1–14, and oxaliplatin was given 130 mg/m2 on day 1, every 21 days. Results: The median age was 61 years with 22% of patients ≥ 70 years. One-third of patients had ECOG 2 - 4, and 33% of patients had signet ring cell histology. Median doses of capecitabine and oxaliplatin achieved were 1500 mg/m2/day (1200 - 2400) and 130mg/m2 (80 - 130) respectively. A median of 5 cycles (range 1 - 8) of XELOX was administered. All 27 patients had toxicity assessment. Toxicities were infrequent and mild. There were 3 cases of grade 3/4 toxicities (thrombocytopenia, neutropenia and fatigue). Twenty-two patients had measurable disease for response evaluation. Complete (CR) and partial (PR) response rates were 9 and 50% respectively. Overall response rate was 59%. Chemo-naïve patients had better responses (80% vs 25%). Four of the remaining 5 patients had reduction in non-measurable disease or in tumor marker levels. Of the 9 patients with ECOG > 1, there was radiological CR in 1 patient and 5 PR; 1 had normalization of CEA, another reversal of disseminated intravascular coagulation and the third decreased ascites. The median time to progression and overall survival were 5.9 months and 7.6 months respectively. Conclusions: XELOX regimen is safe, active and well tolerated in AGC even in patients with poor ECOG status. It is easily administered without requiring a central venous catheter. This regimen should be investigated further in a prospective manner. No significant financial relationships to disclose.

Is there a role for histology based treatment choice in advanced gastric cancer (GC)?

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 135-135
Author(s):  
Rosalba Barile ◽  
Michela Squadroni ◽  
Federica Brena ◽  
Eleonora Cerchiaro ◽  
Valeria Zurlo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Predictive Factors ◽  
Signet Ring Cell ◽  
Histological Diagnosis ◽  
Intestinal Type ◽  
Diffuse Type ◽  
First Line ◽  
Signet Ring ◽  
Ring Cell

135 Background: Medical management of advanced GC is mostly dependent on prognostic assessment based on tumor stage (TNM) and clinical patients (pts)’ characteristics, other than HER2 expression. Prognostic and predictive factors are clearly needed, and histotype could be proposed as a surrogate marker of disease biology. Methods: We retrospectively analyzed pts with advanced GC treated with first line chemotherapy (CT) at Oncology Unit of Humanitas Gavazzeni (Bergamo) and Policlinico Gemelli (Roma). Pts were divided in three subgroups according to histological diagnosis: diffuse type carcinoma, intestinal type carcinoma and signet ring cell carcinoma. HER2 positive tumors were excluded from the analysis. The aim of our analysis was to compare clinical outcomes of metastatic GC pts receiving first line CT according to histological classification (overall survival: OS and Progression Free Survival: PFS). Results: We analyzed 170 pts. Histological diagnosis was as follows: 24.1% (n=41) signet ring cell, 54.4% (n=92) diffuse type, 21.1%(n=37) intestinal type. Pts received a fluoropyrimidine-based doublet containing cisplatin, oxaliplatin or irinotecan; in three drugs regimen anthracycline was added. In diffuse type subgroup OS was: 11.3 months with oxaliplatin based CT, 7.3 months in cisplatin and 6.2 months in irinotecan (p=0.0054); PFS was 5.2, 3.5 and 4.4 months for oxaliplatin, cisplatin and irinotecan based CT respectively (p=0.0036). In signet ring cell carcinomas OS was 12.1 months with oxaliplatin 13.9 with irinotecan, and 5.6 months with cisplatin (p=0.04), and PFS was 6.5, 8.5 and 2.9 months in pts treated with oxaliplatin, cisplatin and irinotecan respectively (p=0.0008). Among pts with intestinal type we did not detect any significant difference in term of OS and PFS comparing first line schedules. Conclusions: Based on our results, histology may be used as a simple, costless and easy tool in advanced gastric cancer treatment management. Clinical use of biomarkers (with the exception for HER2) which are being evaluated as prognostic or predictive factors in GC, is still controversial. In this scenario, the prognostic / predictive value of histology could play a significant role in treatment decision making.

scholarly journals Endometrial signet ring cell metastasis from advanced gastric cancer: case report

2015 ◽  
Vol 26 ◽  
pp. vii134
Author(s):  
Dong Seok Lee ◽  
Moon Ho Kim ◽  
Heui June Ahn ◽  
Ho Suk Oh ◽  
Gil Hyun Kang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Case Report ◽  
Advanced Gastric Cancer ◽  
Signet Ring Cell ◽  
Cancer Case ◽  
Gastric Cancer Case ◽  
Cell Metastasis ◽  
Signet Ring ◽  
Ring Cell

scholarly journals Transcriptome Analysis and the Prognostic Role of NUDC in Diffuse and Intestinal Gastric Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382110195
Author(s):  
Sang-Ho Jeong ◽  
Miyeong Park ◽  
Sun Yi Park ◽  
Jiho Park ◽  
Tae-Han Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Signet Ring Cell ◽  
Negative Group ◽  
Diffuse Type ◽  
Prognostic Role ◽  
Cancer Driver ◽  
Signet Ring ◽  
Ring Cell ◽  
Variant Analysis ◽  
Well Differentiated

Introduction: There have been few studies about gene differences between patients with diffuse-type gastric cancer and those with intestinal-type gastric cancer. The aim of this study was to compare the transcriptomes of signet ring cell gastric cancer (worst prognosis in diffuse-type) and well-differentiated gastric cancer (best prognosis in intestinal-type); NUDC was identified, and its prognostic role was studied. Materials and Methods: We performed next-generation sequencing with 5 well-differentiated gastric cancers and 3 of signet ring cell gastric cancer surgical samples. We performed gene enrichment and functional annotation analysis using the Database for Annotation, Visualization and Integrated Discovery bioinformatics resources. Immunohistochemistry was used to validate NUDC expression. Results: Overall, 900 genes showed significantly higher expression, 644 genes showed lower expression in signet ring cell gastric cancer than in well-differentiated gastric cancers, and there was a large difference in adhesion, vascular development, and cell-to-cell junction components between the 2 subtypes. We performed variant analysis and found 52 variants and 30 cancer driver genes, including NUDC. We analyzed NUDC expression in gastric cancer tissue and its relationship with prognosis. Cox proportional hazard analysis identified T stage, N stage, and NUDC expression as independent risk factors for survival ( P < 0.05). The overall survival of the NUDC-positive group was significantly higher (53.2 ± 0.92 months) than that of the NUDC-negative group (44.6 ± 3.7 months) ( P = 0.001) in Kaplan-Meier survival analysis. Conclusion: We found 30 cancer driver gene candidates and found that the NUDC-positive group showed significantly better survival than the NUDC-negative group via variant analysis.

Optimal care and survival for signet-ring cell and non-signet-ring cell gastric cancer are more achievable at academic cancer centers

2021 ◽  
Author(s):  
Maitham A. Moslim ◽  
Mengying Deng ◽  
Elizabeth Handorf ◽  
Stephanie H. Greco ◽  
Jeffrey M. Farma
Keyword(s):  
Gastric Cancer ◽  
Signet Ring Cell ◽  
Optimal Care ◽  
Cancer Centers ◽  
Signet Ring ◽  
Ring Cell
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