Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 687-698
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.687
Impact of Alcian blue and periodic acid Schiff expression on the prognosis of gastric signet ring cell carcinoma
Juan Lin, Zhu-Feng Chen, Guo-Dong Guo, Xin Chen
Juan Lin, Zhu-Feng Chen, Guo-Dong Guo, Xin Chen, Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Juan Lin, Guo-Dong Guo, Xin Chen, Department of Pathology, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Zhu-Feng Chen, Department of Internal Medicine, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Co-first authors: Juan Lin and Zhu-Feng Chen.
Author contributions: Lin J, Chen ZF, Guo GD, and Chen X contributed to this study; Lin J, Chen ZF, and Chen X contributed to the conception and design of this study; Guo GD collected data; Chen ZF performed the statistical analysis; Lin J conducted the test operations, then drafted and wrote the manuscript; Chen X supervised the entire study; and all authors read and approved the final manuscript.
Supported by the Startup Fund for Scientific Research of Fujian Medical University, No. 2020QH1170.
Institutional review board statement: This study involving human participants was approved by the Ethics Committee of Fujian Provincial Hospital. Approved ID number K2022-09-063.
Informed consent statement: Participants gave informed consent to participate in the study before taking part.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Chen, MBBS, Chief Doctor, Department of Pathology, Fujian Provincial Hospital, No. 134 East Street, Fuzhou 350001, Fujian Province, China. cxc1210@fjmu.edu.cn
Received: November 27, 2023
Peer-review started: November 27, 2023
First decision: December 18, 2023
Revised: December 27, 2023
Accepted: February 6, 2024
Article in press: February 6, 2024
Published online: March 15, 2024
Processing time: 99 Days and 20.3 Hours
ARTICLE HIGHLIGHTS
Research background

There were few studies on the prognosis of patients with gastric signet ring cell carcinoma (SRCC) and the clinical significance in gastric SRCC of the combined Alcian blue (AB) and periodic acid Schiff (PAS) is unclear and controversial.

Research motivation

To explore the prognostic predictors in patients with gastric SRCC.

Research objectives

This study aimed to investigate the AB expression, PAS expression and AB to PAS ratio (A/P) in gastric SRCC and assess the prognosis.

Research methods

A total of 83 patients with gastric SRCC were selected for retrospective analysis and their paraffin-embedded sections were stained by AB and PAS, Ki67, protein 53 (P53) and human epidermal growth factor receptor 2. Kaplan-Meier analysis and Cox proportional-hazard models were used for statistical analyses.

Research results

The 3-year cancer-specific survival rate showed that: (1) High PAS expression group was significantly higher than that of low PAS expression group (P < 0.001); and (2) A/P ≤ 0.5 group was significantly higher than A/P > 0.5 group (P = 0.042). Univariate Cox regression analysis showed that the factors affecting prognosis included tumor diameter, lymph node metastasis, vessel carcinoma embolus, tumor stage, A/P ratio and the expression of Ki67, P53 and PAS. Multivariate Cox regression analysis conformed that low PAS expression and large tumor diameter were independent risk factors for prognosis.

Research conclusions

A/P > 0.5 is a potential risk factor for the prognosis and low PAS expression is an independent risk factor for the prognosis of gastric SRCC. PAS expression and A/P ratio could help in predicting the clinical prognosis of SRCC patients.

Research perspectives

AB and PAS stains can be routinely used for SRCC diagnosis to help determine prognosis.