{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:27:29Z","timestamp":1774978049441,"version":"3.50.1"},"reference-count":106,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T00:00:00Z","timestamp":1698451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Gianesini"},{"name":"Ricerchiamo ONLUS"},{"name":"National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Conflicting results about the prognostic relevance of signet ring cell histology in gastric cancer have been reported. We aimed to perform a meta-analysis focusing on the clinicopathological features and prognosis of this subgroup of cancer compared with other histologies. Methods: A systematic literature search in the PubMed database was conducted, including all publications up to 1 October 2021. A meta-analysis comparing the results of the studies was performed. Results: A total of 2062 studies referring to gastric cancer with signet ring cell histology were identified, of which 262 studies reported on its relationship with clinical information. Of these, 74 were suitable to be included in the meta-analysis. A slightly lower risk of developing nodal metastases in signet ring cell tumours compared to other histotypes was found (especially to undifferentiated\/poorly differentiated\/mucinous and mixed histotypes); the lower risk was more evident in early and slightly increased in advanced gastric cancer. Survival tended to be better in early stage signet ring cell cancer compared to other histotypes; no differences were shown in advanced stages, and survival was poorer in metastatic patients. In the subgroup analysis, survival in signet ring cell cancer was slightly worse compared to non-signet ring cell cancer and differentiated\/well-to-moderately differentiated adenocarcinoma. Conclusions: Most of the conflicting results in signet ring cell gastric cancer literature could be derived from the lack of standardisation in their classification and the comparison with the different subtypes of gastric cancer. There is a critical need to strive for a standardised classification system for gastric cancer, fostering clarity and coherence in the forthcoming research and clinical applications.<\/jats:p>","DOI":"10.3390\/cancers15215191","type":"journal-article","created":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T05:01:08Z","timestamp":1698555668000},"page":"5191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical Features of Gastric Signet Ring Cell Cancer: Results from a Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Mariagiulia","family":"Dal Cero","sequence":"first","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"},{"name":"Section of Gastrointestinal Surgery, Hospital Universitario del Mar, Hospital del Mar Medical Research Institute (IMIM), Department of Surgery, Universitat Aut\u00f2noma de Barcelona, 08003 Barcelona, Spain"}]},{"given":"Maria","family":"Bencivenga","sequence":"additional","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"}]},{"given":"Drolaiz H. W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"},{"name":"Institute of Clinical Pathology and Molecular Pathology, Kepler University Hospital and Johannes Kepler University, 4021 Linz, Austria"}]},{"given":"Michele","family":"Sacco","sequence":"additional","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"}]},{"given":"Mariella","family":"Alloggio","sequence":"additional","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"}]},{"given":"Kelly G. P.","family":"Kerckhoffs","sequence":"additional","affiliation":[{"name":"Department of Pathology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Pathology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands"}]},{"given":"Federica","family":"Filippini","sequence":"additional","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2137-9596","authenticated-orcid":false,"given":"Luca","family":"Saragoni","sequence":"additional","affiliation":[{"name":"Pathology Unit, Morgagni-Pierantoni Hospital, 47100 Forl\u00ec, Italy"}]},{"given":"Mar","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitario del Mar, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain"}]},{"given":"Anna","family":"Tomezzoli","sequence":"additional","affiliation":[{"name":"Department of Pathology, Verona University Hospital, 37134 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-1006","authenticated-orcid":false,"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical Faculty of the University of Porto\/Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o and Ipatimup\/i3S, 4200-319 Porto, Portugal"}]},{"given":"Heike I.","family":"Grabsch","sequence":"additional","affiliation":[{"name":"Department of Pathology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"},{"name":"Division of Pathology and Data Analytics, Leeds Institute of Medical Research at St. James\u2019s, University of Leeds, Leeds LS2 9JT, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5262-8818","authenticated-orcid":false,"given":"Giuseppe","family":"Verlato","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37126 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0707-7153","authenticated-orcid":false,"given":"Lorena","family":"Torroni","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37126 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8243-8310","authenticated-orcid":false,"given":"Guillaume","family":"Piessen","sequence":"additional","affiliation":[{"name":"Department of Digestive and Oncological Surgery, Lille University Hospital, 59000 Lille, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9449-1810","authenticated-orcid":false,"given":"Manuel","family":"Pera","sequence":"additional","affiliation":[{"name":"Section of Gastrointestinal Surgery, Hospital Universitario del Mar, Hospital del Mar Medical Research Institute (IMIM), Department of Surgery, Universitat Aut\u00f2noma de Barcelona, 08003 Barcelona, Spain"}]},{"given":"Giovanni","family":"de Manzoni","sequence":"additional","affiliation":[{"name":"General and Upper GI Surgery Division, Department of Surgery, University of Verona, Borgo Trento Hospital, Piazzale Stefani 1, 37124 Verona, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1038\/s41571-023-00747-0","article-title":"Global burden of gastric cancer: Epidemiological trends, risk factors, screening and prevention","volume":"20","author":"Thrift","year":"2023","journal-title":"Nat. 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