Disappearing Signet Ring Cell Adenocarcinoma in Gastric Cancer Patients

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Diffuse-type gastric cancer incidence is rising globally.
• This subtype exhibits aggressive traits but early-stage (T1a) cancers show better survival than expected.
• T1a diffuse-type cancers with signet ring cell morphology present unique characteristics.

Purpose of the Study:

• To investigate the behavior of T1a signet ring cell gastric cancer.
• To identify potential factors contributing to spontaneous regression in these early-stage cancers.

Main Methods:

• Retrospective analysis of patients with T1a gastric adenocarcinoma and signet ring cell morphology.
• Data collected from 2013-2023 at Memorial Sloan Kettering Cancer Center.
• Exclusion of patients with known CDH1 or CTNNA1 mutations.

Main Results:

• In 7 out of 30 patients, T1a signet ring cell gastric cancer disappeared after initial biopsy.
• Mean follow-up was 50 months.
• No detectable cancer upon subsequent biopsy or resection in these cases.

Conclusions:

• T1a signet ring cell gastric cancers may follow distinct carcinogenic pathways.
• Spontaneous regression could be due to complete removal, immune clearance, or genetic factors.
• Endoscopic surveillance may be suitable for select T1a signet ring cell cancers with careful assessment.