Background: Conflicting results about the prognostic relevance of signet ring cell histology in gastric cancer have been reported. We aimed to perform a meta-analysis focusing on the clinicopathological features and prognosis of this subgroup of cancer compared with other histologies. Methods: A systematic literature search in the PubMed database was conducted, including all publications up to 1 October 2021. A meta-analysis comparing the results of the studies was performed. Results: A total of 2062 studies referring to gastric cancer with signet ring cell histology were identified, of which 262 studies reported on its relationship with clinical information. Of these, 74 were suitable to be included in the meta-analysis. A slightly lower risk of developing nodal metastases in signet ring cell tumours compared to other histotypes was found (especially to undifferentiated/poorly differentiated/mucinous and mixed histotypes); the lower risk was more evident in early and slightly increased in advanced gastric cancer. Survival tended to be better in early stage signet ring cell cancer compared to other histotypes; no differences were shown in advanced stages, and survival was poorer in metastatic patients. In the subgroup analysis, survival in signet ring cell cancer was slightly worse compared to non-signet ring cell cancer and differentiated/well-to-moderately differentiated adenocarcinoma. Conclusions: Most of the conflicting results in signet ring cell gastric cancer literature could be derived from the lack of standardisation in their classification and the comparison with the different subtypes of gastric cancer. There is a critical need to strive for a standardised classification system for gastric cancer, fostering clarity and coherence in the forthcoming research and clinical applications.
背景：关于胃癌中印戒细胞组织学预后相关性的研究结果存在矛盾。本研究旨在通过荟萃分析，比较该亚型与其他组织学类型胃癌的临床病理特征及预后。方法：系统检索截至2021年10月1日PubMed数据库收录的所有相关文献，对纳入研究结果进行荟萃分析。结果：共检索到2062篇涉及印戒细胞组织学胃癌的研究，其中262篇报告了其与临床信息的关系。经筛选，74篇研究符合荟萃分析纳入标准。分析发现：与其他组织学类型（尤其是未分化/低分化/黏液性及混合型）相比，印戒细胞肿瘤发生淋巴结转移的风险略低；这种风险差异在早期胃癌中更为明显，在进展期胃癌中略有增加。早期印戒细胞癌的生存趋势优于其他组织学类型；进展期胃癌中未见显著差异；而转移性患者的生存率较差。亚组分析显示，与非印戒细胞癌及分化型/高-中分化腺癌相比，印戒细胞癌的生存预后略差。结论：现有文献中关于印戒细胞胃癌的矛盾结论，可能源于其分类标准不统一及与不同胃癌亚型的比较差异。亟需建立标准化的胃癌分类体系，以促进未来研究和临床应用的清晰性与一致性。
肿瘤(癌症)患者之家