Deep learning‐based AI model for signet‐ring cell carcinoma diagnosis and chemotherapy response prediction in gastric cancer

2022 ◽  
Author(s):  
Cong Li ◽  
Yun Qin ◽  
Weihan Zhang ◽  
Hanyu Jiang ◽  
Bin Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Deep Learning ◽  
Cell Carcinoma ◽  
Response Prediction ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Chemotherapy Response ◽  
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.

scholarly journals The Clinicopathological Characteristics And Genetic Alterations of Signet-ring Cell Carcinoma in Gastric Cancer

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2318
Author(s):  
Kuo-Hung Huang ◽  
Ming-Huang Chen ◽  
Wen-Liang Fang ◽  
Chien-Hsing Lin ◽  
Yee Chao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Liver Metastasis ◽  
Cell Carcinoma ◽  
Genetic Alterations ◽  
Clinicopathological Characteristics ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Akt Pathway ◽  
Signet Ring ◽  
Ring Cell

Signet-ring cell carcinoma (SRC) in advanced gastric cancer (GC) is often associated with more invasiveness and a worse prognosis than other cell types. The genetic alterations associated with gastric carcinogenesis in SRC are still unclear. In this study, 441 GC patients receiving curative surgery for GC between 2005 and 2013 were enrolled. The clinicopathological characteristics and genetic alterations of GC patients with and without SRC were compared. Among the 441 GC patients, 181 had SRC. For early GC, patients with SRC had more tumors located in the middle and lower stomach, more infiltrating tumors and better overall survival (OS) rates than those without SRC. For advanced GC, patients with SRC had more scirrhous type tumors, more PIK3CA amplifications, fewer microsatellite instability-high (MSI-H) tumors, more peritoneal recurrences and worse 5-year OS rates than those without SRC. For advanced GC with SRC, patients with peritoneal recurrence tended to have PD-L1 expression. For advanced GC without SRC, patients with liver metastasis tended to have PD-L1 expression, PI3K/AKT pathway mutations, TP53 mutations and MSI-H tumors. For advanced GC, PD-L1 expression was associated with peritoneal recurrence in SRC tumors, while non-SRC tumors with liver metastasis were likely to have PI3K/AKT pathway mutations, TP53 mutations and PD-L1 expression; immunotherapy and targeted therapy may be beneficial for these patients.

PS02.242: SIGNET-RING CELL PERCENTAGE MAY INFLUENCE PATHOLOGICAL RESPONSE TO CHEMOTHERAPY IN ESOPHAGO-GASTRIC JUNCTION SIGNET RING CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 191-191
Author(s):  
Andrea Zanoni ◽  
Simone Giacopuzzi ◽  
Jacopo Weindelmayer ◽  
Alessandro Veltri ◽  
Uberto Fumagalli Romario ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Case Series ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Pathological Response ◽  
Response To Treatment ◽  
Cell Percentage ◽  
Signet Ring ◽  
Ring Cell

Abstract Background Like in gastric cancer, the incidence of signet-ring cell carcinoma (SRCC) is rising also in esophago-gastric junction (EGJ) adenocarcinoma Siewert type I and II. SRCC is much more studied in gastric cancer and WHO classification divides poorly cohesive gastric cancer in two subtypes, depending on the percentage of signet-ring cells: real SRCC (percentage of signet-ring cell more than 50%) and poorly cohesive non-SRCC (less than 50%). Real SRCC seems to have higher chemosensitivity and better prognosis than poorly cohesive non-SRCC. Recently, a new classification for SRCC has been proposed, which subdivides SRCC based on different cut-off percentages of signet ring cells (less than or equal to 90% vs more than 90%). Aim of this study was to compare pathological response in patients with EGJ SRCC treated with neoadjuvant chemotherapy. Methods Study population comprised 11 patients with Siewert I and II EGJ SRCC treated with neoadjuvant chemotherapy and surgery. We analyzed differences in pathological response to therapy between ‘pure’-SRCC (more than 90% of SRC) and ‘non-pure’-SRCC (less than or equal to 90%). Tumor regression grade (TRG) was used to define response to treatment, with TRG 1–2 defining good response to treatment and TRG 3–5 poor or absent response to treatment. Results Among the 11 patients with EGJ SRCC, 6 had ‘pure’-SRCC histology and 5 ‘non-pure’-SRCC. Response to treatment in ‘pure’-SRCC patients was equally splint into good and poor responders: 3 had good response to treatment (TRG 1–2) and 3 poor or absent response (TRG 3–5). On the contrary most of ‘non-pure’-SRCC had poor or absent response: 4 out of 5 patients had TRG 3–5. Conclusion Although the case series was too small to perform statistical analyses, our results suggest that signet-ring cell percentage may influence the outcome of neoadjuvant therapy. Probably a larger case series would allow to better define cut-offs of percentage of signet-ring cell carcinoma of the EGJ. Moreover it would allow to inspect other factors related to response to treatment. This is only a preliminary investigation and further studies are needed to better understand the characteristics of these rising in incidence types of cancer. Disclosure All authors have declared no conflicts of interest.

scholarly journals Gastric Adenocarcinomas and Signet-Ring Cell Carcinoma: Unraveling Gastric Cancer Complexity through Microbiome Analysis—Deepening Heterogeneity for a Personalized Therapy

2020 ◽  
Vol 21 (24) ◽  
pp. 9735
Author(s):  
Gloria Ravegnini ◽  
Bruno Fosso ◽  
Viola Di Saverio ◽  
Giulia Sammarini ◽  
Federica Zanotti ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Microbiota Composition ◽  
16S Rrna Analysis ◽  
Linear Discriminant ◽  
Microbial Biomarkers ◽  
Signet Ring ◽  
Ring Cell

Gastric cancer (GC) is the fifth most prevalent cancer worldwide and the third leading cause of global cancer mortality. With the advances of the omic studies, a heterogeneous GC landscape has been revealed, with significant molecular diversity. Given the multifaceted nature of GC, identification of different patient subsets with prognostic and/or predictive outcomes is a key aspect to allow tailoring of specific treatments. Recently, the involvement of the microbiota in gastric carcinogenesis has been described. To deepen this aspect, we compared microbiota composition in signet-ring cell carcinoma (SRCC) and adenocarcinoma (ADC), two distinct GC subtypes. To this purpose, 10 ADC and 10 SRCC and their paired non-tumor (PNT) counterparts were evaluated for microbiota composition through 16S rRNA analysis. Weighted and unweighted UniFrac and Bray–Curtis dissimilarity showed significant community-level separation between ADC and SRCC. Through the LEfSe (linear discriminant analysis coupled with effect size) tool, we identified potential microbial biomarkers associated with GC subtypes. In particular, SRCCs were significantly enriched in the phyla Fusobacteria, Bacteroidetes, Patescibacteria, whereas in the ADC type, Proteobacteria and Acidobacteria phyla were found. Overall, our data add new insights into GC heterogeneity and may contribute to deepening the GC classification.

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.

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