title: The Characteristics and Prognostic Effect of E-Cadherin Expression in Colorectal Signet Ring Cell Carcinoma.
abstract: OBJECTIVE
  Signet ring cell carcinoma (SRCC) is rare. The aim of this study is to understand the clinicopathological features and identify the possible prognostic factors in colorectal SRCC.
  
  
  METHODS
  Patients with SRCC who underwent primary lesion resection at Fudan University Shanghai Cancer Center from September 2008 to July 2014 were retrospectively analyzed. Patient's gender, age, tumor location, depth of invasion, lymph node metastasis, synchronous distant metastasis, perineural invasion, lymphovascular invasion, and E-cadherin expression were studied with prognosis, and the correlation between E-cadherin expression and clinicopathological features were analyzed. All clinicopathological and molecular factors were put into multivariate analysis using Cox proportional hazards model for detecting independent prognostic factors.
  
  
  RESULTS
  59 patients accounting for 0.89% of total colorectal cancer patients met the criteria and were enrolled in the study. The median survival time is 28.9 months, and the 3-year survival rate is 62.7%. SRCC were seen more common in young male patients. Advanced stage was more common in SRCC, 58 (98.3%) patients had T3/T4 lesions, 52 (88.1%) patients had lymph node metastasis, and 14 (23.7%) patients had distant metastasis. Distant metastases were seen more common in peritoneal cavity. Distant metastasis (HR = 4.194, 95% CI: 1.297-13.567), lymphovascular invasion (HR = 2.888, 95% CI: 1.115-7.483), and E-cadherin expression (HR = 0.272, 95% CI: 0.096-0.768) were independent predictors for survival.
  
  
  CONCLUSIONS
  SRCC is a rare subtype of colorectal cancer with poor prognosis. Distant metastasis, lymphovascular invasion, and E-cadherin expression can predict prognosis of colorectal SRCCs independently. More precise therapy and more close surveillance are needed for these patients.
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.
authors: Renjie
authors: R
authors: Wang
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.
authors: Xiaoji
authors: X
authors: Ma
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.
authors: Yaqi
authors: Y
authors: Li
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.|Department of Endoscopy, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.
authors: Yiping
authors: Y
authors: He
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.|Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.
authors: Dan
authors: D
authors: Huang
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.
authors: Sanjun
authors: S
authors: Cai
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China.
authors: Junjie
authors: J
authors: Peng
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015820:Cadherins / Q000378:metabolism*; D018279:Carcinoma, Signet Ring Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult
chemical_list: D015820:Cadherins