Authors: Guillaume Piessen David Amielh Mathieu Messager Edouard Vinatier Emmanuelle Leteurtre Jean Pierre Triboulet Christophe Mariette
Publish Date: 2011/11/19
Volume: 36, Issue: 2, Pages: 346-354
Abstract
Signet ring cell SRC carcinoma is defined as an adenocarcinoma in which 50 of the total operative specimen consists of isolated or small groups of malignant cells containing intracytoplasmic mucins hSRCs We previously demonstrated that hSRCs are a predictor of poor prognosis with specific tumoral characteristics suggesting the need for a dedicated therapeutic strategy before surgery However diagnostic accuracy and prognostic value of SRCs on pretreatment biopsies bSRCs is unknown The aim of the study was to determine if bSRCs can accurately predict hSRCs and survivalA retrospective analysis was performed among 254 patients with an adenocarcinoma We performed pretreatment endoscopic biopsies and histopathologic analysis of the surgical specimen Pretreatment endoscopic biopsy results were compared with definitive pathologic results and were correlated with longterm survivalFrom 254 patients enrolled 96 had bSRCs 378 and 101 398 had hSRCs Pretreatment biopsy results were correct in 89 of 101 patients with hSRC sensitivity 881 and in 146 of 153 with histologic nonSRCs hNSRCs specificity 954 The positive and negative predictive values for the biopsies were 927 and 924 respectively with an overall accuracy of 925 When compared to the biopsy results nonSRCs bNSRCs bSRCs were associated with poorer survival and were identified as an independent factor for poor prognosis hazard ratio 189 with 95 confidence interval 135 to 264 P 0001
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