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Significance of Signet-Ring Cells in Patients with Colorectal Cancer

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Purpose

We performed a retrospective study to determine the pattern of metastases and overall outcome of patients with tumors exhibiting a component of signet-ring cells comprising < 50 percent of the tumor mass.

Methods

Medical records of 753 patients with primary colorectal cancer were retrospectively studied. Patients who had tumors with < 50 percent signet-ring cells were classified as having a component of signet-ring cells. The outcome of patients with a component of signet-ring cells was compared to all patients with mucinous adenocarcinoma (defined as adenocarcinomas with ≥ 50 percent mucin) to all patients with adenocarcinomas with a component of mucin (defined as adenocarcinomas with < 50 percent mucin) and to 100 randomly selected patients with adenocarcinomas lacking mucin or signet-ring cells.

Results

Five percent of patients had a component of signet-ring cells, 3 percent had mucinous adenocarcinoma, 9 percent had a component of mucinous adenocarcinoma, and 83 percent had adenocarcinoma lacking mucinous or signet components. Patients with a component of signet-ring cells and mucinous adenocarcinomas metastasized predominantly to the peritoneum/ovaries (75 and 56 percent of metastatic cases, respectively) and rarely to liver/lungs. The pattern of metastases of patients with adenocarcinoma without mucinous or signet components predominantly involved the liver/lungs and rarely the peritoneum/ovaries (12.5 percent). The pattern of metastases for patients with a component of mucinous adenocarcinoma was intermediate between mucinous adenocarcinoma and adenocarcinoma without mucin or signet-ring component. No differences in survival in Stage IV patients were seen among the four subgroups.

Conclusions

Patients with a component of signet-ring cells cancers, similar to mucinous adenocarcinoma, have a predisposition to metastasize to the peritoneum/ovaries.

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Authors and Affiliations

  1. University at Buffalo/Roswell Park Cancer Institute, Buffalo, New York, USA

    Rashmi Pande M.S.

  2. Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA

    Annette Sunga M.D., M.P.H. & Marwan G. Fakih M.D.

  3. Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York, USA

    Charles LeVea M.D. & Wiam Bshara M.D.

  4. Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, New York, USA

    Gregory E. Wilding Ph.D.

  5. Department of Prevention and Epidemiology, Roswell Park Cancer Institute, Buffalo, New York, USA

    Mary Reid Ph.D.

Authors
  1. Rashmi Pande M.S.
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  2. Annette Sunga M.D., M.P.H.
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  3. Charles LeVea M.D.
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  4. Gregory E. Wilding Ph.D.
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  5. Wiam Bshara M.D.
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  6. Mary Reid Ph.D.
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  7. Marwan G. Fakih M.D.
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Corresponding author

Correspondence to Marwan G. Fakih M.D..

Additional information

Supported in part by a grant from the American Cancer Society (to M.G.F.).

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Pande, R., Sunga, A., LeVea, C. et al. Significance of Signet-Ring Cells in Patients with Colorectal Cancer. Dis Colon Rectum 51, 50–55 (2008). https://doi.org/10.1007/s10350-007-9073-7

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  • DOI: https://doi.org/10.1007/s10350-007-9073-7

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