Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma

Table 3 Overview of studies describing rate of lymphovascular invasion or molecular features

Ref.	LVI +	MSI-H	KRAS	E-cadherin expression
Wei et al[41], 2016	NA	NA	9/54 (16.7%) KRAS. 3/54 (5.6%) NRAS. 2/54 (3.7%) BRAF
Hartmann et al[16], 2013	L: 55% mucin-rich vs 100% mucin-poor (P = 0.002); 56% MSI-H vs 73% MSS (P = 0.25); V: 8% mucin-rich vs 46% mucin-poor (P = 0.004); 4% MSI-H vs 27% MSS (P = 0.06)	23/53 (43%)	16/53 (30%)	NA
Nitsche et al[33], 2013	L: 79% vs 36% (P < 0.001). A: 38% vs 18.37% (P < 0.001)	20% vs 30% (P = 0.644), 155/160 and 15368/25172 missing data	NA	NA
Kakar and Smyrk[44], 2005	NA	22/72 (31%)	NA	NA
Yun et al[63], 2017	L: 60.6% vs 24.8% (P < 0.001). V: 36.6% vs 13.4% (P < 0.001)	NA	NA	NA
Sung et al[21], 2008	Vascular invasion: 58/65 (89%) vs 137/266 (52%; P < 0.0001)	12/63 (19%) vs 21/95 (22%)	NA
Wang et al[43], 2016	NA	NA	NA	23/59 (39%) E-cadherin+ vs 36 (61%) E-cadherin- (P = 0.010)
Nissan et al[18], 1999	Blood vessel invasion: 7.5% vs 22.5% vs 11.9%; LVI: 42.5% vs 2.5% vs 3.5% (P < 0.001); neural invasion: 17.5% vs 7.5% control group vs 4.7% CRC (P < 0.001)	NA
Korphaisarn et al[46], 2019	NA	Deficient MMR: 12.1% vs 9.5% OA with SRC component vs 4.9% (P = 0.10)	Wild type: OR = 7.7, 95%CI: 2.7-22 (P < 0.001)	NA
Lee et al[52], 2007	56% vs 17.4% MA vs 43.3% poorly differentiated OA (P < 0.001)	NA	NA	NA
Bittorf et al[8], 2004	V: 75% vs 34 % and L: 92% vs 54% (P < 0.001)	NA
Bademci et al[28], 2019	22 (88%)	NA	NA	NA
Kakar et al[45], 2012	NA	24% vs 27% MA vs 12% OA (P = 0.52)	52% vs 27% MA vs 40% OA (P = 0.04)	NA
Barresi et al[27], 2016	17/32	7/32	NA	NA
Chew et al[22], 2010	Vascular emboli: 18 (60%) vs 33 (20%) MA vs 587 (23%; P < 0.001)	NA
Nitsche et al[1], 2016	L: 20/30 (67%) vs 23% vs 25% (P < 0.001). Angio-invasion: 5/30 (17%) vs 5% vs 9% (P = 0.18)	1/2 (50%) (P = 0.006) (data only on 251 patients available)
Belli et al[20], 2014	19/22 (86%)	NA
Zhang et al[65], 2020	SRCC + MA: 45.5%	NA	NA	NA
Song et al[66], 2019	75% vs 30.2% mixed vs 21.3% cluster vs 8.6% strip (P < 0.001)	11.1% vs 34.2% mixed vs 23.7% cluster vs 34.2% strip (P = 0.110)	NA	NA
Foda et al[42], 2018	89.5% vs 62.5% MA vs 60.7% OA with mucinous component vs 59.6% OA	NA	NA	26.3% E-cadherin + vs 78.6% MA vs 85.7% OA with mucinous component vs 89.4% OA
Lee et al[29], 2015	7/15 (46.7%) vs 25/75 (33.3%) (P = 0.336)	3/11 (27.3%) vs 10/6 (16.7%; P = 0.486)
Pozos-Ochoa et al[37], 2018	58.3% vs 65% (P = 0.706)	NA	NA	NA
Sasaki et al[14], 1998	NA	NA	4/11 (36.4%) vs 11/29 (37.9%) vs 18/30 (60%) OA

LVI: Lymphovascular invasion; L: Lymphatic invasion; V: Vascular invasion; SRC: Signet-ring cell; SRCC: Signet-ring cell cancer; MA: Mucinous adenocarcinoma; OA: Ordinary/conventional adenocarcinoma; MSI-H: Microsatellite instability-high; MSS: Microsatellite stable; NA: Not applicable; CRC: Colorectal cancer.