Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10969-10978
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10969
Clinical significance of signet ring cells in surgical esophageal and esophagogastric junction adenocarcinoma: A systematic review and meta-analysis
Yi-Fan Wang, Si-Yu Xu, Yan Wang, Guo-Wei Che, Hai-Tao Ma
Yi-Fan Wang, Department of Thoracic Surgery, Affiliated Hospital of Chengdu University, Chengdu 610081, Sichuan Province, China
Yi-Fan Wang, Hai-Tao Ma, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Si-Yu Xu, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yan Wang, Guo-Wei Che, Department of Thoracic Surgery, West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: Ma HT made substantial contributions to the conception and design of the work; Wang YF and Xu SY searched and selected the materials and extracted the data; Wang YF and Xu SY wrote this manuscript; Yan Wang and Che GW revised the paper carefully and also contributed to the statistical analysis; Wang YF and Xu SY contributed equally to this work; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
PRISMA 2009 Checklist statement: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Tao Ma, MD, Professor, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. mht7403@163.com
Received: June 18, 2021
Peer-review started: June 18, 2021
First decision: July 26, 2021
Revised: July 29, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: December 16, 2021
Processing time: 175 Days and 4.4 Hours
Abstract
BACKGROUND

The clinical significance of signet ring cells (SRCs) in surgical esophageal and esophagogastric junction adenocarcinoma (EEGJA) remains unclear now.

AIM

To explore the association between the presence of SRCs and the clinicopathological and prognostic characteristics in surgical EEGJA patients by combining and analyzing relevant studies.

METHODS

The PubMed, Web of Science, and EMBASE electronic databases were searched for the relevant literature up to March 28, 2021. The relative risk (RR) with 95% confidence interval (CI) was calculated to assess the relationship between SRCs and clinicopathological parameters of surgical EEGJA patients, and the hazard ratio (HR) with 95%CI was calculated to explore the impact of SRC on the prognosis. All statistical analyses were conducted with STATA 12.0 software.

RESULTS

A total of ten articles were included, involving 30322 EEGJA patients. The pooled results indicated that the presence of SRCs was significantly associated with tumor location (RR: 0.76, 95%CI: 0.61-0.96, P = 0.022; I2 = 49.4%, P = 0.160) and tumor-node-metastasis stage (RR: 1.30, 95%CI: 1.02-1.65, P = 0.031; I2 = 73.1%, P = 0.002). Meanwhile, the presence of SRCs in surgical EEGJA patients predicted a poor overall survival (HR: 1.36, 95%CI: 1.12-1.65, P = 0.002; I2 = 85.7%, P < 0.001) and disease-specific survival (HR: 1.86, 95%CI: 1.55-2.25, P < 0.001; I2 = 63.1%, P = 0.043).

CONCLUSION

The presence of SRCs is related with advanced tumor stage and poor prognosis and could serve as a reliable and effective parameter for the prediction of postoperative survival and formulation of therapy strategy in EEGJA patients. However, more high-quality studies are still needed to verify the above findings.

Keywords: Signet ring cells; Esophageal and esophagogastric junction adenocarcinoma; Clinicopathological characteristics; Prognosis; Systematic review; Meta-analysis

Core Tip: Our manuscript indicated that the presence of signet ring cells (SRCs) was significantly associated with the tumor location (P = 0.022) and tumor-node-metastasis stage (P = 0.031). Meanwhile, the presence of SRCs in surgical esophageal and esophagogastric junction adenocarcinoma (EEGJA) patients predicted a poor overall survival (P = 0.002) and disease-specific survival (P < 0.001). The presence of SRC was related with advanced tumor stage and poor prognosis and could serve as a reliable and effective parameter for the prediction of postoperative survival and formulation of therapy strategy in EEGJA patients. However, more high-quality studies are still needed to verify the above findings.