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      Clinicopathological Characteristics and Prognostic Value of Signet Ring Cells in Gastric Carcinoma: A Meta-Analysis


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          Background and Objectives: Previous studies of the prognostic value of the signet ring cell (SRC) type have yielded inconsistent results. Therefore, the aim of the present meta-analysis is to explore the clinicopathological characteristics and prognostic value of SRCs.

          Methods: Relevant articles that compared SRC and non-SRC type in PubMed and Web of Science were comprehensively searched. Then, a meta-analysis was performed.

          Results: A total of 19 studies including 35947 cases were analyzed. Compared with non-SRC patients, SRC patients tended to be younger (WMD: -3.88, P=0.001) and predominantly female (OR: 1.60, P<0.001). Additionally, SRC patients exhibited less upper third tumor location (OR: 0.62, P<0.001) and less frequent hematogenous metastasis (OR: 0.41, P<0.001). There was no difference in overall survival (OS) between SRC and non-SRC patients in the total population (HR: 1.02, P=0.830). Early gastric cancer with SRCs was associated with better OS (HR: 0.57, P=0.002), while advanced gastric cancer with non-SRCs was associated with a worse prognosis (HR: 1.17, P<0.001).

          Conclusions: This meta-analysis revealed that SRC tends to affect young females and tends to be located in the middle and lower third of the stomach. Early SRCs are associated with better prognoses, while advanced SRCs are associated with worse prognoses.

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          Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints.

          Meta-analyses aim to provide a full and comprehensive summary of related studies which have addressed a similar question. When the studies involve time to event (survival-type) data the most appropriate statistics to use are the log hazard ratio and its variance. However, these are not always explicitly presented for each study. In this paper a number of methods of extracting estimates of these statistics in a variety of situations are presented. Use of these methods should improve the efficiency and reliability of meta-analyses of the published literature with survival-type endpoints.
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            Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study.

            Endoscopic submucosal dissection (ESD) has the advantage over conventional endoscopic mucosa resection, permitting removal of early gastric cancer (EGC) en bloc, but long-term clinical outcomes remain unknown. A follow-up study on tumour recurrence and survival after ESD was conducted. ESD was performed for patients with EGC that fulfilled the expanded criteria: mucosal cancer without ulcer findings irrespective of tumour size; mucosal cancer with ulcer findings
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              The updated incidences and mortalities of major cancers in China, 2011

              Introduction The National Central Cancer Registry (NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mortalities in 2011 and estimate cancer incident new cases and cancer deaths. Methods In 2014, there were 234 cancer registries that submitted records of new cancer cases and cancer deaths that occurred in 2011 to the NCCR. All datasets were evaluated based on the criteria of data quality of the NCCR. The data of 177 registries was of sufficient quality and was compiled to evaluate cancer statistics in 2011. The pooled data were stratified by area, sex, age group, and cancer type. Cancer incident cases and deaths were estimated using age-standardized rates (ASR) and the Chinese population. All incidences and mortalities were age-standardized to the 2000 Chinese standard population and Segi’s population. Results The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The crude incidence was 250.28/1,00,000 (277.77/1,00,000 for males and 221.37/1,00,000 for females). The ASRs of incidence by the Chinese standard population (ASRIC) and by the world standard population (ASRIW) were 186.34/1,00,000 and 182.76/1,00,000, respectively, with a cumulative incidence (0–74 years old) of 21.20%. Cancers of the lung, female breast, stomach, liver, colorectum, esophagus, cervix, uterus, prostate, and ovary were the most common cancers, accounting for approximately 75% of all new cancer cases. Lung, liver, gastric, esophageal, colorectal, female breast, pancreatic, brain, and cervical cancers and leukemia were the leading causes of cancer death, accounting for approximately 80% of all cancer deaths. Cancer incidence, mortality, and spectrum were all different between urban and rural areas and between males and females. Conclusions The population covered by the cancer registries greatly increased from 2010 to 2011. The data quality and representativeness of cancer registries have gradually improved. Cancer registries have an irreplaceable role in research on cancer prevention and control. The disease burden of cancer is increasing, and the health department must implement effective measures to contain the increased cancer burden in China.

                Author and article information

                J Cancer
                J Cancer
                Journal of Cancer
                Ivyspring International Publisher (Sydney )
                20 September 2017
                : 8
                : 17
                : 3396-3404
                [1 ]Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;
                [2 ]Department of Gastric Surgery, The 6th Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
                Author notes
                ✉ Corresponding author: Ying-Bo Chen,MD: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 E Dongfeng Road, Guangzhou, Guangdong, 510060, China Tel: +86-020-87343625 E-mail: chenyb@ 123456sysucc.org.cn Shi Chen,PhD: The 6th Affiliated Hospital, Sun Yat-sen University, No. 26, YuanCun ErHeng Raod, TianHe District, 510655, Guangzhou,China. Tel: +86-13828496699 E-mail: chensh47@ 123456mail.sysu.edu.cn

                # These authors contributed equally to this study.

                * These authors also contributed equally to this study.

                Competing Interests: The authors have declared that no competing interest exists.

                © Ivyspring International Publisher

                This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.

                : 15 May 2017
                : 31 August 2017
                Research Paper

                Oncology & Radiotherapy
                signet ring cell,gastric cancer,prognosis,survival.
                Oncology & Radiotherapy
                signet ring cell, gastric cancer, prognosis, survival.


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