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Clinicopathological characteristics and prognosis of poorly cohesive cell subtype of gastric cancer

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Abstract

Background

The new World Health Organization (WHO) classification of gastric cancer includes a histological subtype of poorly cohesive carcinoma (PCC), which includes signet-ring cell (SRC) phenotype. We aimed to examine the concordance between preoperative clinical and postoperative histological diagnoses according to the 2010 WHO histological subtypes and to compare the prognoses of these subtypes.

Methods

The study cohort comprised 665 patients who underwent gastrectomy from 2005 to 2019. Histological subtypes were classified into PCC-NOS (non-signet ring cell subtype), SRC, and non-PCC, which were defined by the predominant component in accordance with the 2010 WHO classification of gastric cancer. The concordance of clinical and pathological diagnosis was examined and clinicopathological characteristics and survival outcome of the three subtypes compared.

Results

The cancers of 443 patients (66.7%) were classified as non-PCC, of 112 patients (16.8%) as PCC-NOS, and of 110 patients (16.5%) as SRC predominant subtypes. Significant differences in sex, age, tumor location, size, macroscopic type, and pathological TNM category (all P<0.05) were found. The concordance rate of preoperative and postoperative histological subtypes was significantly lower for poorly cohesive than other subtypes (P<0.0001). Preoperative stage tended to be underestimated for PCC-NOS subtype and these patients had poorer overall survival than those with the other two subtypes (P=0.005). Multivariate logistic regression analysis of overall survival showed that WHO histological subtype (PCC-NOS vs. non-PCC/SRC, HR: 1.64, 95% CI: 1.18–2.29, P=0.0034) was a significant independent prognostic factor.

Conclusion

Our results suggest that poorly cohesive carcinoma subtypes have different biological characteristics and prognoses.

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Acknowledgment

We thank Dr Trish Reynolds, MBBS, FRACP, from Edanz Group (https://en-author-services.edanzgroup.com/) for editing a draft of this manuscript.

Funding

This study had no funding support.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Kenichi Nakamura, Kojiro Eto, Shiro Iwagami, Katsuhiro Ogawa, Hiroshi Sawayama, Masaaki Iwatsuki, Yoshifumi Baba, Yuji Miyamoto, Naoya Yoshida & Hideo Baba

  2. Gastrointestinal Cancer Biology, International Research Center for Medical Sciences, Kumamoto University, Kumamoto, 860-8556, Japan

    Takatsugu Ishimoto

Authors
  1. Kenichi Nakamura
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  2. Kojiro Eto
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  3. Shiro Iwagami
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  4. Katsuhiro Ogawa
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  5. Hiroshi Sawayama
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  6. Takatsugu Ishimoto
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  7. Masaaki Iwatsuki
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  8. Yoshifumi Baba
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  9. Yuji Miyamoto
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  10. Naoya Yoshida
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  11. Hideo Baba
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KN, KE, and SI. The first draft of the manuscript was written by KN and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kenichi Nakamura.

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Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Nakamura, K., Eto, K., Iwagami, S. et al. Clinicopathological characteristics and prognosis of poorly cohesive cell subtype of gastric cancer. Int J Clin Oncol 27, 512–519 (2022). https://doi.org/10.1007/s10147-021-02069-6

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  • DOI: https://doi.org/10.1007/s10147-021-02069-6

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