Prognostic Significance of Signet Ring Cell Component in Mucinous Colorectal Carcinomas

Goblet cell adenocarcinoma (GCA) is a rare amphicrine tumor and difficult to diagnose. GCA is traditionally found in the appendix, but extra-appendiceal GCA may be underestimated. Intestinal adenocarcinoma with signet ring cell component is also very rare, and some signet ring cell carcinomas are well cohesive, having some similar morphological features to GCAs. It is necessary to differentiate GCA from intestinal adenocarcinomas with cohesive signet ring cell component (IACSRCC). The goal of this study is to find occurrence of extra-appendiceal GCA and characterize the histological, immunohistochemical, transcriptional, and immune landscape of GCA. We collected 12 cases of GCAs and 10 IACSRCCs and reviewed the clinicopathologic characters of these cases. Immunohistochemical stains were performed with synaptophysin, chromogranin A, CD56, somatostatin receptor (SSTR) 2, and Ki-67. Whole transcriptome RNA-sequencing was performed, and data were used to analyze differential gene expression and predict immune cell infiltration levels in GCA and IACSRCC. RNA-sequencing data for colorectal adenocarcinoma were gathered from TCGA data portal. Of the 12 patients with GCA, there were 4 women and 8 men. There were three appendiceal cases and nine extra-appendiceal cases. GCAs were immunohistochemically different from IACSRCC. GCA also had different levels of B-cell and CD8+ T-cell infiltration compared to both colorectal adenocarcinoma and cohesive IACSRCCs. Differential gene expression analysis showed distinct gene expression patterns in GCA compared to colorectal adenocarcinoma, with a number of cancer-related differentially expressed genes, including upregulation of TMEM14A, GOLT1A, DSCC1, and HSD17B8, and downregulation of KCNQ1OT1 and MXRA5. GCA also had several differentially expressed genes compared to IACSRCCs, including upregulation of PRSS21, EPPIN, RPRM, TNFRSF12A, and BZRAP1, and downregulation of HIST1H2BE, TCN1, AC069363.1, RP11-538I12.2, and REG4. In summary, the number of extra-appendiceal GCA was underestimated in Chinese patients. GCA can be seen as a distinct morphological, immunohistochemical, transcriptomic, and immunological entity. The classic low-grade component of GCA and the immunoreactivity for neuroendocrine markers are the key points to diagnosing GCA.

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Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1736404 ◽

2021 ◽

Author(s):

Sayali Y. Pangarkar ◽

Akshay D. Baheti ◽

Kunal A. Mistry ◽

Amit J. Choudhari ◽

Vasundhara R. Patil ◽

...

Keyword(s):

Rectal Cancer ◽

Distant Metastasis ◽

Locally Advanced ◽

Prognostic Significance ◽

Signet Ring Cell ◽

Poor Prognostic Factor ◽

Free Survival ◽

Signet Ring ◽

Rectal Cancers ◽

Ring Cell

Abstract Background Presence of extramural venous invasion (EMVI) is a poor prognostic factor for rectal cancer as per literature. However, India-specific data are lacking. Aim The aim of the study is to determine the prognostic significance of EMVI in locally advanced rectal cancer on baseline MRI. Materials and Methods We retrospectively reviewed 117 MRIs of operable non-metastatic locally advanced rectal cancers in a tertiary cancer institute. Three dedicated oncoradiologists determined presence or absence of EMVI, and its length and thickness, in consensus. These patients were treated as per standard institutional protocols and followed up for a median period of 37 months (range: 2–71 months). Kaplan-Meier curves (95% CI) were used to determine disease-free survival (DFS), distant-metastases free survival (DMFS), and overall survival (OS). Univariate analysis was performed by comparing groups with log-rank test. Results EMVI positive cases were 34/114 (29%). More EMVI-positive cases developed distant metastasis compared with EMVI-negative cases (14/34–41% vs. 22/83–26%). The difference, however, was not statistically significant (p = 0.146). After excluding signet-ring cell cancers (n = 14), EMVI showed significant correlation with DMFS (p = 0.046), but not with DFS or OS. The median thickness and length of EMVI was 6 and 14 mm, respectively in patients who developed distant metastasis, as compared with 5 and 11 mm in those who did not, although this difference was not statistically significant. Conclusion EMVI is a predictor of distant metastasis in locally advanced non-metastatic, non-signet ring cell rectal cancers. EMVI can be considered another high-risk feature to predict distant metastasis.

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Prognostic significance of frequent CLDN18-ARHGAP26/6 fusion in gastric signet-ring cell cancer

Nature Communications ◽

10.1038/s41467-018-04907-0 ◽

2018 ◽

Vol 9 (1) ◽

Cited By ~ 21

Author(s):

Yang Shu ◽

Weihan Zhang ◽

Qianqian Hou ◽

Linyong Zhao ◽

Shouyue Zhang ◽

...

Keyword(s):

Cell Cancer ◽

Prognostic Significance ◽

Signet Ring Cell ◽

Signet Ring ◽

Ring Cell

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Different clinicopathologic features and prognostic significance of signet ring cell histology in early and locally advanced gastric cancer patients

Clinics and Research in Hepatology and Gastroenterology ◽

10.1016/j.clinre.2020.05.006 ◽

2020 ◽

pp. 101454 ◽

Cited By ~ 2

Author(s):

Bochao Zhao ◽

Huiwen Lu ◽

Rui Luo ◽

Shiyang Bao ◽

Di Mei ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Locally Advanced ◽

Prognostic Significance ◽

Signet Ring Cell ◽

Clinicopathologic Features ◽

Locally Advanced Gastric Cancer ◽

Signet Ring ◽

Ring Cell ◽

Gastric Cancer Patients

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Higher incidence of EGFR exon 19 deletion in younger (age 40 or younger) patients with adenocarcinoma of the lung.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.7044 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 7044-7044

Author(s):

Eri Sugiyama ◽

Koichi Goto ◽

Genichiro Ishii ◽

Shigeki Umemura ◽

Kiyotaka Yoh ◽

...

Keyword(s):

Elderly Patients ◽

Lung Adenocarcinoma ◽

Signet Ring Cell ◽

Egfr Mutations ◽

Cell Component ◽

Younger Patients ◽

Signet Ring ◽

Exon 19 Deletion ◽

Ring Cell ◽

Exon 19

7044 Background: The proportion of younger patients (≤ 40 years) with lung cancer is reported to be 2-5%. The most frequent histologic type of them is adenocarcinoma, however little is known about the pathological and molecular characteristics of younger patients with lung adenocarcinoma. Methods: Between July 1992 and April 2011, a total of 7443 patients were diagnosed as lung cancer in National Cancer Center Hospital East and 165 patients of whom (2.2%) who were 40 years or younger were identified. Among them, 44 patients with adenocarcinoma who underwent surgical resection were selected for this study. In addition, 185 elderly patients with > 40 years who underwent surgical resection matching gender and smoking status were selected as a control group. Histological predominant growth pattern and any coexisting variant pattern, the status of EGFR mutations were compared between these two groups. Results: The median age in ≤ 40 years patients was 37 years (range, 21 to 40 years) and that in elderly patients was 68 years (range, 42 to 83 years). Between these two groups, there were no significant differences in the distribution of histological predominant growth patterns (lepidic; 31.8% vs. 26.5%, papillary; 34.1% vs. 37.3%, acinar; 9.1% vs. 16.2%, and solid; 25.0% vs. 20.0%, p=0.78) and the incidence of EGFR mutations (40.9% vs. 45.9%; p=0.55). However, signet-ring cell component were significantly found in the younger patients than elderly (11.4% vs. 0%; p<0.01). The incidence of EGFR exon 19 deletion was significantly higher in younger patients than elderly, in contrast, that of EGFR exon 21 L858R was significantly higher in elderly patients (exon 19 del; 31.7% vs. 18.9%, L858R; 4.6% vs. 25.4%, p=0.0091). Three of 17 adenocarcinomas (17.7%) with EGFR-wild type in younger patients showed positive for ALK translocation. Conclusions: Younger patients with lung adenocarcinoma showed significantly higher proportion of EGFR exon 19 deletion genotype and containing histologically signet-ring cell component comparing with elderly patients. EGFR exon 19 deletion genotype may be related to pathogenesis of lung adenocarcinoma in younger patients.

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Acantholytic squamous cell carcinoma of the lung showing significant signet ring cell component

Histopathology ◽

10.1111/his.12762 ◽

2015 ◽

Vol 68 (3) ◽

pp. 463-465 ◽

Cited By ~ 3

Author(s):

Heae Surng Park ◽

Sungsoo Lee

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Signet Ring Cell ◽

Cell Component ◽

Signet Ring ◽

Ring Cell ◽

Acantholytic Squamous Cell Carcinoma

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Incidence and Prognostic significance of Signet Ring Cell Histology in Gastric Cancer. A cross sectional study from Turkey: Pure Signet Ring Cell Histology in Gastric Cancer

10.32592/ircmj.2020.22.9.34 ◽

2020 ◽

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Poor Prognosis ◽

Prognostic Significance ◽

Good Prognosis ◽

Signet Ring Cell ◽

Stage I ◽

Stage Iii ◽

Signet Ring ◽

Ring Cell

Purpose: The present study aims to evaluate the incidence of signet ring cell (SRC) histology in patients with gastric cancer and its prognostic significance on the disease stage. Methods: Between November 2006 and September 2019, 309 patients were reviewed retrospectively in Kartal Koşuyolu High Specialization Training and Research Hospital Gastroenterology Surgery clinic in Turkey and the clinicopathological features and survival status were examined in the presence of ring cell histology. Results: Of the patients, 71.4% had gastric cancer with a non-SRC histology and 28.6% had an SRC histology. The presence of an SRC histology was found to be associated with young age (p=0.007), advanced depth of wall invasion (p=0.001), number of positive lymph nodes (p=0.022) and presence of vascular invasion (p=0.044). The presence of an SRC histology was associated with good prognosis in patients with stage I gastric cancer (p=0.045), but with poor prognosis in patients with stage III disease (p=0.034). The study found no significant association between stage II disease and overall survival. Conclusions: The present study found survival to be associated with good prognosis in stage I, and poor prognosis in stage III among patients with gastric cancer with SRC histology. No prognostic significance could be established for overall survival.

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