Endoscopic and clinicopathologic features of early gastric signet ring cell carcinoma ≤20 mm: a retrospective observational study

Abstract

Objectives

Limited literature exists on the characteristics of early gastric signet ring cell carcinoma (GSRCC) within 20 mm. This study aimed to explore this type of cancer from several aspects, to provide guidance for early detection and intervention of GSRCC.

Methods

We retrospectively collected data from 24 patients diagnosed with early GSRCC ≤20 mm in Beijing Friendship Hospital from 2016 to 2021. According to tumor size, those lesions were divided into three groups: diminutive group (1–5 mm, n = 4), small group (6–10 mm, n = 12) and intermediate group (11–20 mm, n = 8). The clinicopathologic and endoscopic characteristics of GSRCC were compared among the three groups.

Results

Treatment strategies for lesions differed according to the size (p<.05). There were no significant differences among the three groups with regard to age, sex, Helicobacter pylori infection, tumor location and macroscopic type. Lesions were often flat type and more likely to present with discoloration, uneven color, ulceration and submucosal invasion with the increase of diameter. Almost all cases showed abnormal intervening part (IP) under magnifying endoscopy.

Conclusions

The location of early signet ring cell carcinoma is not specific, and the diminutive lesions are often flat. Abnormal IP may be the early endoscopic feature of early GSRCC.

Keywords:

• Early gastric cancer
• signet ring cell carcinoma
• endoscopic appearance
• pathological features
• diagnosis

Acknowledgements

We would like to thank Rongxue Li at our hospital for her help of reviewing endoscopic images in our study.

Author contributions

Conceptualization and design: JNX, JYZ and HHZ. Acquisition, analysis or interpretation of data: all authors. Drafting of the first manuscript: JNX and JYZ. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: JNX, JYZ, ZYL and LHL. Supervision and project administration: HHZ. All authors have read and approved the final version of the manuscript submitted.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

The original data used to support the findings of this study are available from the corresponding author upon request.