A Clinical Study on Signet Ring Cell Type of Gastric Adenocarcinoma

In the past gastric carcinomas composed predominantly of signet ring cells formed only a small percentage of gastric malignancies. However. we have had the impression that in recent years the relative incidence and amount of signet ring cells in biopsy and resection specimens of gastric carcinoma have risen sharply. This report is an analysis of 69 cases of signet ring cell type of gastric adenocarcinoma diagnosed at Ewha Womens University Hospital from January, 1987 to December, 1991. The results obtained were summerized as follows.

1) The male to female ratio was 1:1.2.

2) The peak age incidence was the 6th decade and the 7th decade with 23.9% each other, and the 8th decade with 17.4%, the 5th decade and the 4th decade with 16% each other. Average age of patients was younger than entire gastric adenocarcinoma.

3) The major clinical symptom was epigastric pain, indigestion, vomiting and abdominal fullness in decreasing orders.

4) The macroscopic feature of the signet ring cell type of adenocarcinoma by gastronberscopy showed Borrmann's type III 26 cases(37.6%), type IV 21 cases(30.4%), type II 10 cases(14.5%).

5) The location of signet ring cell type was mainly the gastric antrum 39 cases(56.5%), the body 18 cases(26%), and widespread from body to antrum 9 cases(13%).

6) The size of lesion showed above 3cm with 53%, 1.5~3.0cm with 31.3%, below 1.5cm with 15.7% in frequency.

7) Thirty out of 39 cases(76.9%) involve to the serosa, 3 cases(7.7%) to the muscle layer, 3 cases(7.7%) to the mucosa and the submucosa each other.

8) Distant metastases were relatively frequently occurred in increased CEA group.

9) Five-year survival rate of 49 cases was 62.8%.