Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5217-5229
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5217
Protective effects of female reproductive factors on gastric signet-ring cell carcinoma
Yang Li, Yu-Xin Zhong, Quan Xu, Yan-Tao Tian
Yang Li, Yu-Xin Zhong, Quan Xu, Yan-Tao Tian, Department of Pancreatic and Gastric Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: All of the authors contributed to this work; Li Y and Tian YT designed the research study and performed the research; Li Y collected the data, performed the statistical analysis, and drafted the manuscript; Li Y, Zhong YX, Xu Q, and Tian YT participated in discussion and manuscript revision; All authors have read and approve the final version of the manuscript and agreed to be accountable for all aspects of the work.
Supported by National Natural Science Foundation of China, No. 82072734.
Institutional review board statement: Ethical approval was obtained through the Chinese Academy of Medical Science (Beijing, China).
Informed consent statement: All participants gave written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data included in this study are available on reasonable request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Tao Tian, MD, Chief Doctor, Department of Pancreatic and Gastric Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 South Panjiayuan Lane, Suite 806, Surgical Building, Chaoyang District, Beijing 100021, China. tianyantao@cicams.ac.cn
Received: September 14, 2021
Peer-review started: September 14, 2021
First decision: October 18, 2021
Revised: October 21, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 6, 2022
ARTICLE HIGHLIGHTS
Research background

Gastric signet-ring cell carcinoma (GSRC) is a distinct type of gastric cancer (GC), and its incidence has been steadily increasing. GSRC in early and advanced stages is more frequently observed in younger female patients than in gastric adenocarcinomas.

Research motivation

The effect of female reproductive factors on GSRC tumorigenesis and tumor development remains unclear.

Research objectives

The purpose of this study was to estimate the effects of female reproductive factors on the prognosis of GSRC.

Research methods

Our study involved 1431 participants who were histologically confirmed with GC with signet-ring cells and underwent curative resections between January 2011 and December 2018 at the Cancer Hospital, Chinese Academy of Medical Sciences, China. Cox multivariable model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between sex factors and survival of GC patients with signet-ring cell carcinoma. Subgroup analyses were conducted by: (1) Body mass index; (2) Signet-ring cell proportion; (3) Adjuvant chemotherapy; (4) Neoadjuvant chemotherapy; (5) Nerve invasion; and (6) Lymphatic vessel invasion to explore if the impact of the sex difference was stronger in certain groups.

Research results

The menstrual female subjects had a significantly lower risk of mortality (HR = 0.58, 95%CI: 0.42–0.82) than male participants in the multivariable model. The effect appeared to be more substantial among certain subgroup analyses.

Research conclusions

There was a stronger positive association with overall survival in menstrual female patients with GSRC, compared to in male or menopause female patients.

Research perspectives

Future studies with a more specific measure of signet-ring cells in GC and more comprehensive long-term outcomes (e.g., the recurrence or chemoresistance, could offer more information) will be needed to verify the conclusion in this study.