BACKGROUND Signet-ring cell carcinoma(SRCC)is a rare subtype of colorectal cancer.The incidence of primary colonic SRCC is relatively rare in pediatric patients,with a limited number of reported cases currently availa...BACKGROUND Signet-ring cell carcinoma(SRCC)is a rare subtype of colorectal cancer.The incidence of primary colonic SRCC is relatively rare in pediatric patients,with a limited number of reported cases currently available.The prognosis for this specific tumor type is unfavorable,and the preoperative diagnosis presents challenges,potentially leading to misdiagnosis.This case report describes the diagnosis of primary SRCC in the colon of a 10-year-old girl.CASE SUMMARY The patient was admitted to the hospital due to abdominal pain and vomiting.A computed tomography scan revealed an irregular mass with soft tissue density in her transverse colon,showing uneven density and multiple calcifications.The patient underwent surgical resection of the affected bowel and lymph node dissection,which was confirmed by pathological examination to be SRCC infiltrating both nerves and the entire intestinal wall.Additionally,tumor thrombus formation was observed in blood vessels and lymphatic vessels,multiple cancerous nodules were found in the omentum,and metastasis to 18 of 26 mesenteric lymph nodes examined.Immunohistochemistry for mismatch repair gene protein demonstrated microsatellite stability.No mutations in KRAS,NRAS,BRAF,or PIK3CA genes were detected through molecular pathology analysis.After surgery,she received standard chemotherapy for 8 cycles without tumor progression or other abnormalities during a 12-month follow-up period CONCLUSION Primary colonic SRCC is a rare malignant tumor with atypical clinical symptoms,and timely identification and intervention are crucial for improving the prognosis.展开更多
The distribution and ultrastructural localization of CEA in signet-ring cells of 15 gastric cancer specimens were observed by PAP and immunoelectron microscopic methods. The mechanism of abnormal distribution of CEA i...The distribution and ultrastructural localization of CEA in signet-ring cells of 15 gastric cancer specimens were observed by PAP and immunoelectron microscopic methods. The mechanism of abnormal distribution of CEA in the signet-ring cell and its biological significance are discussed. The results showed that the CEA positive rate in signet-ring cells was 100% with the polarity lost in distribution. Under the light microscope, the CEA stain patterns were of two types: cytoplasmic and membranous types. The former was predominant. Under the electron microscope, most of the CEA was distributed on the cell membrane and cytoplasm. CEA was found in intracellular membranous structure of the cancer cells, especially in protein synthesis and transport organellae (RER, Golgi Complex etc.). The synthesis of CEA in cancer cells increased, yet its elimination was somewhat hampered. The result was that the RER became extended and were full of CEA (+) material. In the free signet-ring cell, there was a small and short contact plane. The tight junction was severed as the cell junction reduced. The antigenic determinant of CEA was glycoprotein. The abnormal distribution of CEA in signet-ring cells might be the morphologic reflection of the glycosylation of surface glycoprotein of tumor cells.展开更多
While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gas...While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer,which can be resected endoscopically in some cases and which has a better outcome than non-SRCC,and advanced gastric cancer,which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. However,the prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. It therefore remains unclear if a specific therapeutic strategy is justified,as the benefit of perioperative chemotherapy and the value of taxanebased chemotherapy are unclear. In this review we analyze recent data on the epidemiology,oncogenesis,prognosis and specific therapeutic strategies in both early and advanced SRCC of the stomach and in hereditary diffuse gastric cancer.展开更多
AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been tr...AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.展开更多
Objective:Signet ring cell carcinoma is a rare subtype of colorectal carcinoma(CRC)with an associated BRAFV600E mutation.We investigated frequencies of BRAF mutation in 28 CRCs containing variable signet ring cell com...Objective:Signet ring cell carcinoma is a rare subtype of colorectal carcinoma(CRC)with an associated BRAFV600E mutation.We investigated frequencies of BRAF mutation in 28 CRCs containing variable signet ring cell component and their relation with clinicopathologic parameters.Methods:According to the presence of signet ring cell component,tumors were categorized into groups as follows:0%–9%,10%–24%,25%–49%,and>50%.Genomic DNA was isolated and analyzed for BRAF V600E gene mutation by polymerase chain reaction-restriction fragment length polymorphism.Eleven of 28 cases(39.3%)showed BRAFV600E mutation,which was also confirmed by Sanger sequencing.To elucidate the importance of existence of signet ring cell component at the molecular level,we separated cases into two groups with cut-off levels of 10%and 50%,which pertain to percentages of signet ring cells.Results:Seven of 19 cases(36.8%)under the threshold of 50%and four of nine cases(44.4%)over this threshold value demonstrated BRAF mutation.Three of 7 cases(42.8%)featuring<10%signet ring cell component and eight out of 21 cases(38.1%)showing>10%were BRAF mutated.Conclusions:BRAF mutation must be closely associated with the presence of malignant signet ring cells regardless of their percentages.展开更多
BACKGROUND Synchronous multiple primary cancers (SMPC) mean two or more malignant tumors occurring simultaneously and with different origins no matter what types they are or where they are located. The carcinogenesis ...BACKGROUND Synchronous multiple primary cancers (SMPC) mean two or more malignant tumors occurring simultaneously and with different origins no matter what types they are or where they are located. The carcinogenesis of SMPC often involves variations of some specific genes. However, the correlation between CDH1 mutations and synchronous multiple primary gastrointestinal cancers is largely unknown. CASE SUMMARY A 62-year-old woman had sustained abdominal pain for one week and visited our hospital. Gastrointestinal endoscopy revealed multiple small polypoid lesions in both the stomach and colorectum. Computed tomography and laboratory results were within normal limits. Pathological evaluation confirmed signet ring cell carcinoma without obvious metastatic evidence. Malignant cells showed negativity for E-cadherin and positivity for β-catenin in the cytoplasm and nucleus. DNA sequencing performed on paraffin-embedded tissue revealed two exactly coincident alterations in CDH1, C.57T>G and C.1418A>T. CONCLUSION This case suggests that the combination of CDH1 mutations and WNT/β-catenin signaling activation contributes to the carcinogenesis of gastrointestinal SMPC.展开更多
目的:探讨6例伴印戒细胞分化的原发性乳腺癌的临床病理特征、免疫表型、诊断和鉴别诊断。方法:对6例伴印戒细胞分化的原发性乳腺癌的临床特点、病理学特征、免疫组化特点等进行分析,并复习相关文献。结果:6例患者均为女性,平均年龄45岁...目的:探讨6例伴印戒细胞分化的原发性乳腺癌的临床病理特征、免疫表型、诊断和鉴别诊断。方法:对6例伴印戒细胞分化的原发性乳腺癌的临床特点、病理学特征、免疫组化特点等进行分析,并复习相关文献。结果:6例患者均为女性,平均年龄45岁,均因发现乳腺肿块而就诊。镜下肿瘤细胞呈印戒状,胞浆内可见大空泡,核被挤于一侧,呈弥漫性、巢状及条索状分布于乳腺纤维间质中。6例中有3例为单纯型的印戒细胞癌,3例合并其他类型浸润性乳腺癌。免疫组化显示:6例中有5例肿瘤细胞ER为阳性,3例E-Cad her in阳性。6例中Her-2(3+)1例、Her-2(2+)2例、Her-2(1+)3例。6例中5例均有腋窝淋巴结转移。5例行乳腺改良根治切除术,1例行单纯乳腺切除术。2例分别于术后3年及4年发生远处转移。6例至随访结束均存活。结论:伴印戒细胞分化的乳腺癌的病理诊断主要依赖于其特征性组织学表现与免疫组化染色特点。与其他类型乳腺浸润性癌相比,伴印戒细胞分化的乳腺癌更具侵袭性,预后较差。展开更多
目的探究胃印戒細胞癌(signet ring cell careinoma,SRC)与非印戒细胞型胃腺癌(non-signet ring cell adenocarinoma.NSRC)的临床病理学特征及预后是否存在差异。方法回颐性收集2008年1月至2019年12月在中山大学附属第六医院行根治性胃...目的探究胃印戒細胞癌(signet ring cell careinoma,SRC)与非印戒细胞型胃腺癌(non-signet ring cell adenocarinoma.NSRC)的临床病理学特征及预后是否存在差异。方法回颐性收集2008年1月至2019年12月在中山大学附属第六医院行根治性胃大部分切除术或全胃切除术治疗的胃癌患者资料,分析胃SRC组与NSRC组的各项临床病理资料的差异,并对两组的总生存率进行比较。然后采取倾向性评分匹配法对协变量进行匹配,比较匹配后胃SRC组与NSRC组的总生存率差异,并通过Cox比例风险回归模型分析影响胃癌患者预后的因素。结果共1050例患者纳人分析,其中胃SRC组122例,NSRC组928例。两组在年龄、性别、肿瘤部位、手术方式、T分期、N分期、肿瘤TNM分期CEA、腹膜转移等方面比较差异有统计学意义(P<0.05),两组的总生存率差异无统计学意义。对所有协变最进行匹配后,SRC组115例,NSRC组291例,两组的Ⅰ期患者的总生存率差异无统计学意义(P>0.05),对于Ⅱ-Ⅳ期的患者,胃SRC的总生存率比NSRC患者差,差异有统计学意义(P<005)。Cox多因素分析结果表明:SRC(HR=1.76,95%6 C1:1.0429,-004)、年龄≥60岁(HR=2.18,95%CI:1.22-3.91,P=0.008)、较高的T分期(T_(3),HR=9.34,95%C1:2.32~37.59,P=0.002;T_(4),HR=13.40,95%C1:3.00~59.77,P=0.001)、较高的N分期(N_(2),HR=2.98,95%CI:1.45~6.12,P=0.003;N_(3),HR=2.47,95%CI:1.09-5.62,P=0.03)是胃癌总生存率不良的独立危险因素,而BMI>18.5 kg/m^(2)是保护性因素。结论胃SRC是胃癌的一种特殊组织学类型,有着独特的临床病理学特征和预后表现,对于Ⅰ期胃癌患者,胃SRC患者的预后与NSRC患者相当,对于Ⅱ-Ⅳ期SRC患者的预后明则显差于NSRC患者。展开更多
基金Supported by the Health Research Project of Kunming Municipal Health Commission,China,No.2023-01-04-001.
文摘BACKGROUND Signet-ring cell carcinoma(SRCC)is a rare subtype of colorectal cancer.The incidence of primary colonic SRCC is relatively rare in pediatric patients,with a limited number of reported cases currently available.The prognosis for this specific tumor type is unfavorable,and the preoperative diagnosis presents challenges,potentially leading to misdiagnosis.This case report describes the diagnosis of primary SRCC in the colon of a 10-year-old girl.CASE SUMMARY The patient was admitted to the hospital due to abdominal pain and vomiting.A computed tomography scan revealed an irregular mass with soft tissue density in her transverse colon,showing uneven density and multiple calcifications.The patient underwent surgical resection of the affected bowel and lymph node dissection,which was confirmed by pathological examination to be SRCC infiltrating both nerves and the entire intestinal wall.Additionally,tumor thrombus formation was observed in blood vessels and lymphatic vessels,multiple cancerous nodules were found in the omentum,and metastasis to 18 of 26 mesenteric lymph nodes examined.Immunohistochemistry for mismatch repair gene protein demonstrated microsatellite stability.No mutations in KRAS,NRAS,BRAF,or PIK3CA genes were detected through molecular pathology analysis.After surgery,she received standard chemotherapy for 8 cycles without tumor progression or other abnormalities during a 12-month follow-up period CONCLUSION Primary colonic SRCC is a rare malignant tumor with atypical clinical symptoms,and timely identification and intervention are crucial for improving the prognosis.
文摘The distribution and ultrastructural localization of CEA in signet-ring cells of 15 gastric cancer specimens were observed by PAP and immunoelectron microscopic methods. The mechanism of abnormal distribution of CEA in the signet-ring cell and its biological significance are discussed. The results showed that the CEA positive rate in signet-ring cells was 100% with the polarity lost in distribution. Under the light microscope, the CEA stain patterns were of two types: cytoplasmic and membranous types. The former was predominant. Under the electron microscope, most of the CEA was distributed on the cell membrane and cytoplasm. CEA was found in intracellular membranous structure of the cancer cells, especially in protein synthesis and transport organellae (RER, Golgi Complex etc.). The synthesis of CEA in cancer cells increased, yet its elimination was somewhat hampered. The result was that the RER became extended and were full of CEA (+) material. In the free signet-ring cell, there was a small and short contact plane. The tight junction was severed as the cell junction reduced. The antigenic determinant of CEA was glycoprotein. The abnormal distribution of CEA in signet-ring cells might be the morphologic reflection of the glycosylation of surface glycoprotein of tumor cells.
文摘While the incidence of gastric cancer has decreased worldwide in recent decades,the incidence of signetring cell carcinoma(SRCC) is rising. SRCC has a specific epidemiology and oncogenesis and has two forms: early gastric cancer,which can be resected endoscopically in some cases and which has a better outcome than non-SRCC,and advanced gastric cancer,which is generally thought to have a worse prognosis and lower chemosensitivity than non-SRCC. However,the prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. It therefore remains unclear if a specific therapeutic strategy is justified,as the benefit of perioperative chemotherapy and the value of taxanebased chemotherapy are unclear. In this review we analyze recent data on the epidemiology,oncogenesis,prognosis and specific therapeutic strategies in both early and advanced SRCC of the stomach and in hereditary diffuse gastric cancer.
文摘AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.
文摘Objective:Signet ring cell carcinoma is a rare subtype of colorectal carcinoma(CRC)with an associated BRAFV600E mutation.We investigated frequencies of BRAF mutation in 28 CRCs containing variable signet ring cell component and their relation with clinicopathologic parameters.Methods:According to the presence of signet ring cell component,tumors were categorized into groups as follows:0%–9%,10%–24%,25%–49%,and>50%.Genomic DNA was isolated and analyzed for BRAF V600E gene mutation by polymerase chain reaction-restriction fragment length polymorphism.Eleven of 28 cases(39.3%)showed BRAFV600E mutation,which was also confirmed by Sanger sequencing.To elucidate the importance of existence of signet ring cell component at the molecular level,we separated cases into two groups with cut-off levels of 10%and 50%,which pertain to percentages of signet ring cells.Results:Seven of 19 cases(36.8%)under the threshold of 50%and four of nine cases(44.4%)over this threshold value demonstrated BRAF mutation.Three of 7 cases(42.8%)featuring<10%signet ring cell component and eight out of 21 cases(38.1%)showing>10%were BRAF mutated.Conclusions:BRAF mutation must be closely associated with the presence of malignant signet ring cells regardless of their percentages.
基金Supported by the National Science Foundation of China,Nos.81770624 and 81860490Foundation of Jiangxi Educational Committee,No.GJJ160048Foundation of Health and Family Planning Commission of Jiangxi Province,No.20171098
文摘BACKGROUND Synchronous multiple primary cancers (SMPC) mean two or more malignant tumors occurring simultaneously and with different origins no matter what types they are or where they are located. The carcinogenesis of SMPC often involves variations of some specific genes. However, the correlation between CDH1 mutations and synchronous multiple primary gastrointestinal cancers is largely unknown. CASE SUMMARY A 62-year-old woman had sustained abdominal pain for one week and visited our hospital. Gastrointestinal endoscopy revealed multiple small polypoid lesions in both the stomach and colorectum. Computed tomography and laboratory results were within normal limits. Pathological evaluation confirmed signet ring cell carcinoma without obvious metastatic evidence. Malignant cells showed negativity for E-cadherin and positivity for β-catenin in the cytoplasm and nucleus. DNA sequencing performed on paraffin-embedded tissue revealed two exactly coincident alterations in CDH1, C.57T>G and C.1418A>T. CONCLUSION This case suggests that the combination of CDH1 mutations and WNT/β-catenin signaling activation contributes to the carcinogenesis of gastrointestinal SMPC.
文摘目的:探讨6例伴印戒细胞分化的原发性乳腺癌的临床病理特征、免疫表型、诊断和鉴别诊断。方法:对6例伴印戒细胞分化的原发性乳腺癌的临床特点、病理学特征、免疫组化特点等进行分析,并复习相关文献。结果:6例患者均为女性,平均年龄45岁,均因发现乳腺肿块而就诊。镜下肿瘤细胞呈印戒状,胞浆内可见大空泡,核被挤于一侧,呈弥漫性、巢状及条索状分布于乳腺纤维间质中。6例中有3例为单纯型的印戒细胞癌,3例合并其他类型浸润性乳腺癌。免疫组化显示:6例中有5例肿瘤细胞ER为阳性,3例E-Cad her in阳性。6例中Her-2(3+)1例、Her-2(2+)2例、Her-2(1+)3例。6例中5例均有腋窝淋巴结转移。5例行乳腺改良根治切除术,1例行单纯乳腺切除术。2例分别于术后3年及4年发生远处转移。6例至随访结束均存活。结论:伴印戒细胞分化的乳腺癌的病理诊断主要依赖于其特征性组织学表现与免疫组化染色特点。与其他类型乳腺浸润性癌相比,伴印戒细胞分化的乳腺癌更具侵袭性,预后较差。
文摘目的探究胃印戒細胞癌(signet ring cell careinoma,SRC)与非印戒细胞型胃腺癌(non-signet ring cell adenocarinoma.NSRC)的临床病理学特征及预后是否存在差异。方法回颐性收集2008年1月至2019年12月在中山大学附属第六医院行根治性胃大部分切除术或全胃切除术治疗的胃癌患者资料,分析胃SRC组与NSRC组的各项临床病理资料的差异,并对两组的总生存率进行比较。然后采取倾向性评分匹配法对协变量进行匹配,比较匹配后胃SRC组与NSRC组的总生存率差异,并通过Cox比例风险回归模型分析影响胃癌患者预后的因素。结果共1050例患者纳人分析,其中胃SRC组122例,NSRC组928例。两组在年龄、性别、肿瘤部位、手术方式、T分期、N分期、肿瘤TNM分期CEA、腹膜转移等方面比较差异有统计学意义(P<0.05),两组的总生存率差异无统计学意义。对所有协变最进行匹配后,SRC组115例,NSRC组291例,两组的Ⅰ期患者的总生存率差异无统计学意义(P>0.05),对于Ⅱ-Ⅳ期的患者,胃SRC的总生存率比NSRC患者差,差异有统计学意义(P<005)。Cox多因素分析结果表明:SRC(HR=1.76,95%6 C1:1.0429,-004)、年龄≥60岁(HR=2.18,95%CI:1.22-3.91,P=0.008)、较高的T分期(T_(3),HR=9.34,95%C1:2.32~37.59,P=0.002;T_(4),HR=13.40,95%C1:3.00~59.77,P=0.001)、较高的N分期(N_(2),HR=2.98,95%CI:1.45~6.12,P=0.003;N_(3),HR=2.47,95%CI:1.09-5.62,P=0.03)是胃癌总生存率不良的独立危险因素,而BMI>18.5 kg/m^(2)是保护性因素。结论胃SRC是胃癌的一种特殊组织学类型,有着独特的临床病理学特征和预后表现,对于Ⅰ期胃癌患者,胃SRC患者的预后与NSRC患者相当,对于Ⅱ-Ⅳ期SRC患者的预后明则显差于NSRC患者。
