Annals of Coloproctology

Original Articles

Clinical Significance of Signet-Ring-Cell Colorectal Cancer as a Prognostic Factor: Sang-Oh Yun, Yong Beom Cho, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yoon Ah Park, Jung Wook Huh; Ann Coloproctol. 2017;33(6):232-238. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.232

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Purpose

The aim of this study is to evaluate the prognosis for patients with a signet-ring-cell carcinoma (SRCC) who undergo curative surgery by comparing them to patients with an adenocarcinoma (ADC), excluding a mucinous ADC.

Methods

Between September 1994 and December 2013, 14,110 patients with colorectal cancer underwent surgery and among them, 12,631 patients were enrolled in this study. 71 patients with a SRCC and 12,570 patients with a ADC were identified. We analyzed the disease-free survival and the overall survival rates before and after a 1:2 propensity score matching and evaluated those rates after stage stratification.

Results

The median follow-up durations were 48.5 months for the SRC group and 48.6 months for the ADC group. The disease-free survival rates and the overall survival rates were significantly lower in the SRC group before and after propensity score matching (P < 0.001). After stratification by stage, no differences were observed between the SRC and the ADC groups for the disease-free survival (DFS) and the overall survival (OS) rates for patients with cancer in its early stages (P = 0.913 and P = 0.380 for the DFS and the OS, respectively, in stages 0 and I, and P = 0.223 and P = 0.991 for the DFS and the OS, respectively, in stage II), but those rates were significantly lower in the SRC group for cancer in its later stages (P < 0.001, respectively in stages III and IV).

Conclusion

For cancer in advanced stages, patients with a resectable colorectal SRCC had a poorer prognosis after propensity score matching than those with an ADC did. Therefore, more intensive surveillance and closer observation should be offered to such patients.

Citations

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Nan Yao, Wenqiang Li, Jiwei Wang, Hongyuan Chu, Ning Duan, Xinyu Niu, Guoyong Yu, Jun Qu
BMJ Open.2024; 14(2): e076579. CrossRef
Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma
Frederiek Nuytens, Vincent Drubay, Clarisse Eveno, Florence Renaud, Guillaume Piessen
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Case report: Preclinical efficacy of NEDD8 and proteasome inhibitors in patient-derived models of signet ring high-grade mucinous colorectal cancer from a Lynch syndrome patient
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Predictors of Long-Time Survivors in Nonmetastatic Colorectal Signet Ring Cell Carcinoma: A Large Population-Based Study
Wuguang Zhang, Wenqian Gong, Changhai Wu, Mengting Li, Xiaolong Tu, Stephen Fink
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Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
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Does signet ring cell carcinoma component signify worse outcomes for patients with colorectal cancer?
Liming Wang, Yasumitsu Hirano, Gregory Heng, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Nao Obara, Masahiro Asari, Takuya Kato, Shigeki Yamaguchi
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The Impact of Histologic Subtype on Receipt of Adjuvant Chemotherapy and Overall Survival in Stage III Colon Cancer: a Retrospective Cohort Analysis
Benjamin D. Powers, Seth I. Felder, Iman Imanirad, Sophie Dessureault, Sean P. Dineen
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Colorectal adenocarcinomas diagnosed following a negative faecal immunochemical test show high‐risk pathological features in a colon screening programme
Michael J. Steel, Hussam Bukhari, Laura Gentile, Jennifer Telford, David F. Schaeffer
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Clinicopathological factors and survival outcomes of signet-ring cell and mucinous carcinoma versus adenocarcinoma of the colon and rectum: a systematic review and meta-analysis
Michael G. Fadel, George Malietzis, Vasilis Constantinides, Gianluca Pellino, Paris Tekkis, Christos Kontovounisios
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MRI features of signet ring rectal cancer
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Prognostic factors influencing survival in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for isolated colorectal peritoneal metastases: a systematic review and meta‐analysis
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Colorectal Disease.2020; 22(11): 1482. CrossRef
Deconvolution of diffuse gastric cancer and the suppression of CD34 on the BALB/c nude mice model
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BMC Cancer.2020;[Epub] CrossRef
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Rebekah M. Engel, Karen Oliva, Christine Koulis, Raymond Yap, Paul J. McMurrick
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Clinicopathological Characteristics and Mutation Spectrum of Colorectal Adenocarcinoma With Mucinous Component in a Chinese Cohort: Comparison With Classical Adenocarcinoma
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Signet ring cell component in pretreatment biopsy predicts pathological response to preoperative chemoradiotherapy in rectal cancer
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Outcomes of Definitive Treatment of Signet Ring Cell Carcinoma of the Rectum: Is Minimal Invasive Surgery Detrimental in Signet Ring Rectal Cancers?
S. Raghavan, Deepak Kumar Singh, J. Rohila, A. DeSouza, R. Engineer, A. Ramaswamy, V. Ostwal, A. Saklani
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Blake Read, Patricia Sylla
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Xiaoli Wu, Han Lin, Shaotang Li
BMC Gastroenterology.2019;[Epub] CrossRef

Prognostic Impact of Microsatellite Instability in Colorectal Cancer Presenting With Mucinous, Signet-Ring, and Poorly Differentiated Cells: Sang Hun Jung, So Hyun Kim, Jae Hwang Kim; Ann Coloproctol. 2016;32(2):58-65. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.58

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16 Citations

Abstract PDF

Purpose

Mucinous cells (MUCs), signet-ring cells (SRCs), and poorly differentiated cells (PDCs) are uncommon histologic types and have been associated with advanced tumor stage and poor prognosis. However, MUCs, SRCs, and PDCs are commonly observed in cancers with high microsatellite instability (MSI), which have favorable outcomes compared with cancers with microsatellite stability (MSS). The purpose of this study was to evaluate the prognostic impact of high-MSI in patients with sporadic colorectal cancer presenting with MUCs, SRCs, and/or PDCs.

Methods

Between January 2006 and December 2012, 176 with proven microsatellite status who also presented with MUCs, SRCs, and PDCs were selected for this study and were divided into 2 groups, high-MSI and MSS; their outcomes were analyzed.

Results

Of the 176 patients, 56 and 120, respectively, had high-MSI and MSS cancers. High-MSI cancers had larger tumors, proximal tumor location, and a lower TNM stage. The recurrence rate was lower in the high-MSI group (13.7% vs. 35.4%, P = 0.006). Common patterns of distant metastasis for MUC, SRC, PDC cancers were peritoneal spread (46.9%) and hematogenous metastasis (46.4%). The 5-year CSS rates were 88.2% and 61.2% for patients with high-MSI and MSS cancers, respectively (P < 0.0001). In the multivariate analysis, except for stage-IV cancer, MSI status was an independent risk factor for cancer-specific survival (MSS: hazard ratio, 4.34; 95% confidence interval, 1.68-11.21).

Conclusion

In patients with colorectal cancer presenting with MUCs, SRCs, and/or PDCs, those with high-MSI cancers had better outcomes.

Citations

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Correlation of clinical, pathologic, and genetic parameters with intratumoral immune milieu in mucinous adenocarcinoma of the colon
Azfar Neyaz, Amaya Pankaj, Andrew Crabbe, Steffen Rickelt, Lieve Leijssen, Anne Dinaux, Martin Taylor, Stuti G. Shroff, Rory Crotty, M. Lisa Zhang, Omer H. Yilmaz, Osman Yılmaz, Deepa T. Patil, Aparna R. Parikh, David T. Ting, David Berger, Vikram Deshpan
Modern Pathology.2022; 35(11): 1723. CrossRef
The Molecular Associations of Signet-Ring Cell Carcinoma in Colorectum: Meta-Analysis and System Review
Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
Medicina.2022; 58(7): 836. CrossRef
Rate of dissemination and prognosis in early and advanced stage colorectal cancer based on microsatellite instability status: systematic review and meta-analysis
James W. T. Toh, Kevin Phan, Faizur Reza, Pierre Chapuis, Kevin J. Spring
International Journal of Colorectal Disease.2021; 36(8): 1573. CrossRef
Tumour infiltrating lymphocyte status is superior to histological grade, DNA mismatch repair and BRAF mutation for prognosis of colorectal adenocarcinomas with mucinous differentiation
David S. Williams, Dmitri Mouradov, Marsali R. Newman, Elham Amini, David K. Nickless, Catherine G. Fang, Michelle Palmieri, Anuratha Sakthianandeswaren, Shan Li, Robyn L. Ward, Nicholas J. Hawkins, Iain Skinner, Ian Jones, Peter Gibbs, Oliver M. Sieber
Modern Pathology.2020; 33(7): 1420. CrossRef
Prognostic value of KRAS mutation status in colorectal cancer patients: a population-based competing risk analysis
Dongjun Dai, Yanmei Wang, Liyuan Zhu, Hongchuan Jin, Xian Wang
PeerJ.2020; 8: e9149. CrossRef
Implication of Microsatellite Instability in Chinese Cohort of Human Cancers

Meiying Cui, Pan Li, Ying Mao, Lan Zhang, Peiyi Xia, Enjie Liu, Weiwei Wang, Jianying Zhang, Guozhong Jiang, Wencai Li
Cancer Management and Research.2020; Volume 12: 10287. CrossRef
Outcomes for Metastatic Colorectal Cancer Based on Microsatellite Instability: Results from the South Australian Metastatic Colorectal Cancer Registry
Li Chia Chong, Amanda Rose Townsend, Joanne Young, Amitesh Roy, Cynthia Piantadosi, Jennifer E. Hardingham, David Roder, Christos Karapetis, Robert Padbury, Guy Maddern, James Moore, Timothy Jay Price
Targeted Oncology.2019; 14(1): 85. CrossRef
Signet ring cell colorectal cancer: genomic insights into a rare subpopulation of colorectal adenocarcinoma
Krittiya Korphaisarn, Van Morris, Jenifer S. Davis, Michael J. Overman, David R. Fogelman, Bryan K. Kee, Arvind Dasari, Kanwal P. S. Raghav, Imad Shureiqi, Metha Trupti, Robert A. Wolff, Cathy Eng, David G. Menter, Stanley Hamilton, Scott Kopetz
British Journal of Cancer.2019; 121(6): 505. CrossRef
SILAC-Based Quantification of TGFBR2-Regulated Protein Expression in Extracellular Vesicles of Microsatellite Unstable Colorectal Cancers
Fabia Fricke, Malwina Michalak, Uwe Warnken, Ingrid Hausser, Martina Schnölzer, Jürgen Kopitz, Johannes Gebert
International Journal of Molecular Sciences.2019; 20(17): 4162. CrossRef
Is microsatellite instability-high really a favorable prognostic factor for advanced colorectal cancer? A meta-analysis
Bingyan Wang, Fei Li, Xin Zhou, Yanpeng Ma, Wei Fu
World Journal of Surgical Oncology.2019;[Epub] CrossRef
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Mabel Elena Bohórquez L, Ángel Alexandro Criollo R, Luis Carvajal Carmona, María Magdalena Echeverry de Polanco
Revista de la Asociación Colombiana de Ciencias Biológicas.2019; : 87. CrossRef
Evaluation of Long-Term Outcomes of Microsatellite Instability Status in an Asian Cohort of Sporadic Colorectal Cancers
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Mismatch Repair Proteins and Microsatellite Instability in Colorectal Carcinoma (MLH1, MSH2, MSH6 and PMS2): Histopathological and Immunohistochemical Study
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Impact of Microsatellite Instability in Signet-Ring Cell and Mucinous Components in Patients With Colorectal Carcinoma
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Case Report

Signet Ring Cell Carcinoma Arising from a Solitary Juvenile Polyp in the Colon: Hae Jung Kim, Min Kwan Kang, Hee Suk Lee, Do Sun Kim, Du Han Lee; J Korean Soc Coloproctol. 2010;26(5):365-367. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.365

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6 Citations

Abstract PDF

Juvenile polyps are relatively common polyps that affect predominantly young patients and may occur in isolated, multiple, and/or familial forms. They have been considered to be benign lesions without neoplastic potential, but for patients with multiple juvenile polyposis, the cumulative malignant risk is greater than fifty percents. In patients with a solitary polyp, the risks are minimal, and only a few cases of malignant change from a solitary juvenile polyp have been reported. We describe the case of a twenty one year old female with one solitary juvenile polyp, which contained a signet ring cell carcinoma in the mucosal layer.

Citations

Citations to this article as recorded by

Solitary juvenile polyp of the rectum with intramucosal adenocarcinoma
Kazuki Nagai, Uichiro Fuchizaki, Yoshimichi Ueda
Clinical Journal of Gastroenterology.2023; 16(4): 532. CrossRef
Cancer risk and mortality in patients with solitary juvenile polyps—A nationwide cohort study with matched controls
Anne Marie Jelsig, Laus Wullum, Tine Plato Kuhlmann, Lilian Bomme Ousager, Johan Burisch, John Gásdal Karstensen
United European Gastroenterology Journal.2023; 11(8): 745. CrossRef
Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China
Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
BMC Gastroenterology.2022;[Epub] CrossRef
Can a Solitary Juvenile Polyp Be Regarded as a Nonmalignant Polyp?
Kumiko Fukami, Makoto Furihata, Shintaro Yano, Hiroki Okawa, Shinjiro Nishi, Yoichi Nakatsu, Yusuke Nomoto, Shingo Ogiwara, Tsuneo Kitamura, Shigeki Tomita, Taro Osada
ACG Case Reports Journal.2022; 9(12): e00936. CrossRef
Ultrasonography with the colonic segment-approach for colonic polyps in children
Yu Wang, Xiao Man Wang, Li Qun Jia
Pediatric Radiology.2019; 49(13): 1735. CrossRef
Signet ring cell carcinoma in a juvenile polyp
Carmen Villar Lucas, Mercedes Hernando Martín, Begoña Álvarez-Cuenllas
Revista Española de Enfermedades Digestivas.2019;[Epub] CrossRef

Original Article

Characteristics of Primary Colorectal Signet Ring Cell Carcinoma.: Kim, In Kyoung , Lee, Ryung Ah , Hwang, Dae Yong , Lee, Seung Sook , Noh, Woo Chul , Bang, Ho Yoon , Choi, Dong Wook , Lee, Jong Inn , Paik, Nam Sun , Moon, Nan Mo; J Korean Soc Coloproctol. 2001;17(5):267-272.

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Abstract PDF: PURPOSE
Primary colorectal signet ring cell carcinoma is a rare disease entity and there is little information compare to ordinary colorectal adenocarcinoma. The aim of this study was to acknowledge the differences of clinicopathological features between colorectal signet ring cell carcinoma and ordinary colorectal adenocarcinoma.
METHODS
The author analyzed clinicopathological aspects of 742 consecutive surgical patients with colorectal carcinoma operated at Korean Cancer Center Hospital between January 1993 and December 1999. 19 patients with primary colorectal signet ring cell carcinoma were identified. Clinicopathological features and survival data were evaluated in comparison with those of the ordinary colorectal adenocarcinoma in a retrospective study matched for age, gender, and stage.
RESULTS
19 (2.6%) cases of primary signet ring cell carcinoma were identified and 26 (3.5%) cases of mucinous adenocarcinoma were identified. Male-to-female ratio of the signet ring cell carcinoma was 1.4:1. Mean age was 44 16 years and median age was 41year (range, 22-73 year). No patient had Stage I disease. The majority of patients had an advanced tumor stage at the time of diagnosis (15.8 percents StageII, 68.4 percents Stage III, and 15.8 percents Stage IV). Median survival time was only 29months (P=0.0084). In a study matched for age, gender, and stage, a lower survival rate was found for patients with signet ring cell carcinoma (P=0.0021). In contrast to ordinary adenocarcinoma, signet ring cell carcinoma was characterized by a significantly higher incidence of locoregional recurrence (50%) and peritoneal tumor spread (30%), but a lower incidence of hematogenous metastases (10%).
CONCLUSIONS
Primary signet ring cell colorectal carcinoma represents a rare and is frequently diagnosed in an advanced tumor stage, thus showing an overall poorer prognosis than ordinary colorectal carcinoma. A high incidence of locoregional recurrence and peritoneal seeding and a low incidence of hematogenous metastasis are characteristics of signet-ring cell carcinoma. This different pattern of tumor biology would be justified to different management of primary colorectal signet ring cell carcinoma.

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