Clinicopathological, immunohistochemical, and overall-survival associations of poorly cohesive gastric carcinoma stratified by signet ring cell percentage
Yi-Han Zheng, Yang-Yang Wang, Shu-Chang Wang, Chao-Jie Wang, Yan-Ying Shen, Jian-Zhi Cui, Shi-Meng Liu, Ye-Hao Zhang, Xue-Qin Zeng, En-Hao Zhao
Yi-Han Zheng, Yang-Yang Wang, Shu-Chang Wang, Chao-Jie Wang, Jian-Zhi Cui, Shi-Meng Liu, Ye-Hao Zhang, En-Hao Zhao, Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Yan-Ying Shen, Xue-Qin Zeng, Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Co-first authors: Yi-Han Zheng and Yang-Yang Wang.
Co-corresponding authors: Xue-Qin Zeng and En-Hao Zhao.
Author contributions: Zheng YH and Wang YY contributed to the manuscript writing; Zheng YH, Wang SC, and Wang CJ contributed to the statistical analysis; Zeng XQ and Shen YY contributed to the pathological study; Zheng YH, Cui JZ, Liu SM, and Zhang YH contributed to the follow-up of the patients and the data collection; Zeng XQ contributed to the basis for pathological grouping; Zeng XQ and Zhao EH contributed to the critical revision of the manuscript; Zhao EH contributed to the supervision and organization of the study. Zeng XQ and Zhao EH contributed equally to this work as co-corresponding authors. Zheng YH and Wang YY contributed equally to this work as co-first authors.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by the Natural Science Foundation of Shanghai Municipality, No. 23ZR1439400 to Zhao EH; the National Natural Science Foundation of China, No. 82103348 to Wang YY; and the Fundamental Research Funds for the Central Universities, No. YG2023QNA10 to Wang SC.
Institutional review board statement: This retrospective observational study was conducted in accordance with the ethical principles of the Declaration of Helsinki. The study was approved by the Ethics Committee of Renji Hospital, Shanghai Jiao Tong University School of Medicine (Ethics Approval No. LY2022-091-B).
Informed consent statement: The Ethics Committee waived the requirement for informed consent due to the study's retrospective nature and the use of anonymized data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: En-Hao Zhao, MD, PhD, Chief Physician, Professor, Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Road, Shanghai 200127, China.
zhaoenhao@renji.com
Received: July 1, 2026
Revised: August 24, 2026
Accepted: October 16, 2026
Published online: October 24, 2026
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