Prognostic value of signet-ring cell carcinoma proportion in undifferentiated gastric cancer: Implications for endoscopic treatment decisions

Figure 1 Patients according to the signet ring cell carcinoma group. SRCC: Signet ring cell carcinoma.

Figure 2 Histologic features of signet ring cell carcinoma groups. Representative hematoxylin and eosin-stained images of gastric carcinoma showing varying proportions of signet-ring cell (SRC) components. The signet ring cell carcinoma (SRCC) group. A: Group 1: SRCC rate < 10%; B: Group 2: 10% ≤ SRCC rate < 50%; C: Group 3: 50% ≤ SRCC rate < 90%; D: Group 4: SRCC rate ≥ 90%. SRCs (arrow) are characterized by intracytoplasmic mucin and eccentrically displaced nuclei, while poorly cohesive carcinoma not otherwise specified cells (arrowhead) lack these features. Original magnification × 200 for all panels.

Figure 3 Signet ring cell carcinoma rate. A: Pathological tumor category (P < 0.001); B: Pathological node category (P < 0.001); C: Pathological metastasis category (P = 0.0012). SRCC: Signet ring cell carcinoma; pT: Pathological tumor category; pN: Pathological node category; pM: Pathological metastasis category; AJCC: American Joint Committee on Cancer.

Figure 4 Recurrent free survival and overall survival according to the signet ring cell carcinoma group. A and C: Recurrent free survival; B and D: Overall survival. SRCC: Signet ring cell carcinoma.

Figure 5 Association of signet ring cell carcinoma rates with prognostic factors in early-stage gastric cancer with undifferentiated-type histology. A: Signet ring cell carcinoma (SRCC) rates according to lymph nodal metastasis; B: SRCC rates according to presence of ulcer; C: SRCC rates according to tumor size; D: SRCC rates in early-stage gastric cancer subgroup; E: Submucosal invasion depth (μm) according to SRCC group; F: SRCC rates according to submucosal invasion level. SRCC: Signet ring cell carcinoma; EGC: Early-stage gastric cancer.