Clinicopathological characteristics of colorectal signet-ring cell carcinoma (SRCC)

doi:10.3877/cma.j.issn.2095-3224.2024.03.008

Abstract

Abstract:

Objective

Signet-ring cell carcinoma (SRCC) is a special subtype of colorectal cancer with extremely poor prognosis and poor clinical treatment effect. Due to its relative rarity, the expression signature of its clinicopathological features, especially the immune microenvironment, is currently unknown.

Methods

In this study, seventy-nine SRCC cases were enrolled in Cancer Hospital Chinese Academy of Medical Sciences and 156 tubular adenocarcinoma (TC) cases were matched. Clinical and pathological data and prognosis information were collected, and immunohistochemical markers related to immune microenvironment were stained to compare the differences between the two groups.

Results

SRCC was more likely to occur ≤60 years old (χ²=12.35, P<0.01), proximal colon (χ²=10.91, P<0.01). T、N、M stage of SRCC was later (all P<0.01) and more likely to harbour tumor thrombus (χ²=24.16, P<0.01). The prognosis (PFS) is poor (HR=4.19, P<0.01), and the mode of SRCC progression is mainly peritoneal dissemination but less distant metastasis.The presence of CD8⁺ T on the immune microenvironment showed fewer cells and low PD-L1 expression, but significantly increased numbers of macrophages (all P<0.01).

Conclusion

Colorectal SRCC is a highly malignant histological subtype with unique biological behavior and immune microenvironment characteristics.

Key words: Colorectal neoplasms, Signet-ring cell carcinoma, Pathology, Immunotherapy

Long Wang, Shuai Wu, Bingzhi Wang, Bo Zheng, Wenbin Li, Shuangmei Zou. Clinicopathological characteristics of colorectal signet-ring cell carcinoma (SRCC)[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(03): 229-235.

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References 40

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临床特征	分组		χ²值	P值
临床特征	TC（n=156）	SRCC（n=79）	χ²值	P值
性别			0.31	0.579
女	53（33.97）	24（30.38）
男	103（66.03）	55（69.62）
年龄（岁）			12.35	<0.001*
≤60	75（48.08）	57（72.15）
>60	81（51.92）	22（27.85）
位置			10.91	0.004*
乙状结肠/直肠	126（80.76）	49（62.03）
右半结肠	15（9.62）	19（24.05）
左半结肠/横结肠	15（9.62）	11（13.92）
T分期			37.68	<0.001*
T1	14（8.97）	2（2.53）
T2	29（18.59）	4（5.06）
T3	72（46.15）	20（25.32）
T4	41（26.28）	53（67.09）
N分期			64.87	<0.001*
N0	84（53.85）	12（15.19）
N1	44（28.21）	11（13.92）
N2	28（17.95）	56（70.89）
M分期			11.33	0.001*
M0	152（97.44）	68（86.08）
M1	4（2.56）	11（13.92）
脉管瘤栓			24.16	<0.001*
无	127（81.41）	40（50.63）
有	29（18.59）	39（49.37）

临床特征	分组		χ²值	P值
临床特征	TC（n=156）	SRCC（n=79）	χ²值	P值
性别			0.31	0.579
女	53（33.97）	24（30.38）
男	103（66.03）	55（69.62）
年龄（岁）			12.35	<0.001*
≤60	75（48.08）	57（72.15）
>60	81（51.92）	22（27.85）
位置			10.91	0.004*
乙状结肠/直肠	126（80.76）	49（62.03）
右半结肠	15（9.62）	19（24.05）
左半结肠/横结肠	15（9.62）	11（13.92）
T分期			37.68	<0.001*
T1	14（8.97）	2（2.53）
T2	29（18.59）	4（5.06）
T3	72（46.15）	20（25.32）
T4	41（26.28）	53（67.09）
N分期			64.87	<0.001*
N0	84（53.85）	12（15.19）
N1	44（28.21）	11（13.92）
N2	28（17.95）	56（70.89）
M分期			11.33	0.001*
M0	152（97.44）	68（86.08）
M1	4（2.56）	11（13.92）
脉管瘤栓			24.16	<0.001*
无	127（81.41）	40（50.63）
有	29（18.59）	39（49.37）

指标	分组		χ²值	P值
指标	TC（n=111）	SRCC（n=60）	χ²值	P值
HER2			28.38	0.033
-	93（83.78）	57（95.00）
+	18（16.22）	3（5.00）
C-MET			96.94	<0.001
0	16（14.41）	33（55.00）
1+	15（13.51）	22（36.67）
2+	68（61.26）	5（8.33）
3+	12（10.81）	0
SATB2			4.74	0.030
-	12（10.81）	14（23.33）
+	99（89.19）	46（76.67）
MMR			4.93	0.248
pMMR	110（99.10）	58（96.67）
dMMR	1（0.90）	2（3.33）

指标	分组		χ²值	P值
指标	TC（n=111）	SRCC（n=60）	χ²值	P值
HER2			28.38	0.033
-	93（83.78）	57（95.00）
+	18（16.22）	3（5.00）
C-MET			96.94	<0.001
0	16（14.41）	33（55.00）
1+	15（13.51）	22（36.67）
2+	68（61.26）	5（8.33）
3+	12（10.81）	0
SATB2			4.74	0.030
-	12（10.81）	14（23.33）
+	99（89.19）	46（76.67）
MMR			4.93	0.248
pMMR	110（99.10）	58（96.67）
dMMR	1（0.90）	2（3.33）

指标	中位数（Q25，Q75）	Z值	P值
CD8		-1.246	0.213
TC	1.927（0.972，3.544）
SRCC	2.146（1.137，5.399）
GZMB		-6.939	<0.001
TC	0.159（0.091，0.372）
SRCC	0.796（0.402，1.609）
GZMB/CD8		-3.873	<0.001
TC	0.101（0.044，0.257）
SRCC	0.299（0.120，0.532）
CD68		-9.099	<0.001
TC	0.447（0.183，1.444）
SRCC	8.541（4.487，14.223）
CD163		10.501	<0.001
TC	3.851（1.385，9.662）
SRCC	0.029（0.001，0.148）
CD163/CD68		9.448	<0.001
TC	5.576（2.308，13.020）
SRCC	0.003（0.001，0.020）
PD1		5.183	<0.001
TC	4.427（0.232，18.600）
SRCC	0.259（0.001，1.376）
PD-L1 CPS评分		2.944	<0.001
TC	0（0，5）
SRCC	0（0，0）

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