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. 2019 Nov 8;19(1):178.
doi: 10.1186/s12876-019-1094-x.

Rapidly Declining Trend of Signet Ring Cell Cancer of the Stomach May Parallel the Infection Rate of Helicobacter Pylori

Free PMC article

Rapidly Declining Trend of Signet Ring Cell Cancer of the Stomach May Parallel the Infection Rate of Helicobacter Pylori

Hiroshi Ohyama et al. BMC Gastroenterol. .
Free PMC article


Background: Studies indicate that gastric cancer (GC) incidence has decreased, whereas signet ring cell carcinoma (SRC) incidence has increased. However, recent trends in GC incidence are unclear. We used our hospital cancer registry to evaluate the changes in the incidence of GC, SRC, and non-SRC (NSRC) over time in comparison to changes in the H. pylori infection rates over time.

Methods: We identified 2532 patients with GC enrolled in our registry between January 2007 and December 2018 and statistically analyzed SRC and NSRC incidence. The H. pylori infection rate in patients with SRC was determined by serum anti-H. pylori antibody testing, urea breath test, biopsy specimen culture, and immunohistochemical analysis (IHC) of gastric tissue. Additionally, genomic detection of H. pylori was performed in SRCs by extracting DNA from formalin-fixed paraffin-embedded gastric tissue and targeting 16S ribosomal RNA of H. pylori.

Results: Overall, 211 patients had SRC (8.3%). Compared with patients with NSRC, those with SRC were younger (P < 0.001) and more likely to be female (P < 0.001). Time series analysis using an autoregressive integrated moving average model revealed a significant decrease in SRC (P < 0.001) incidence; NSRC incidence showed no decline. There was no difference in H. pylori infection prevalence between the SRC and NSRC groups. IHC and genomic methods detected H. pylori in 30 of 37 (81.1%) SRCs.

Conclusions: Reduction in H. pylori infection prevalence may be associated with the decrease in the incidence of SRC, which was higher than that of NSRC.

Keywords: Epidemiology; Genomic detection; Helicobacter pylori; Signet ring cell carcinoma; Time series analysis.

Conflict of interest statement

The authors declare that they have no competing interests.


Fig. 1
Fig. 1
(a) Age distribution of patients with SRC (blue line) and NSRC (red line). (b) Relationship between birth-year and the number of patients with SRC. (c) Relationship between birth-year and the number of patients with NSRC. Curved lines indicate approximate curves
Fig. 2
Fig. 2
(a) The number of registered SRC and NSRC cases from 2007 to 2018 (the ratio of the total number of SRC and NSRC cases during the period of 2007–2012 and 2013–2018). P value was calculated by the Mann–Whitney U test (P < 0.001). b–d Time series analysis of the number of SRC (b) and NSRC (c) cases and the SRC/NSRC ratio (d) using autoregressive integrated and moving average (ARIMA) model. Raw data of time series achieved stationarity using differencing. Subsequently, autoregressive moving average model was applied to the series. The fitted model was used to forecast the incidence. The annual number of SRC cases and the SRC/NSRC ratio significantly decreased (P < 0.001 and P = 0.002, respectively). NS, not significant

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    1. Pernot S, Voron T, Perkins G, Lagorce-Pages C, Berger A, Taieb J. Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol. 2015;21:11428–11438. doi: 10.3748/wjg.v21.i40.11428. - DOI - PMC - PubMed
    1. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process- first American Cancer Society award lecture on Cancer epidemiology and prevention. Cancer Res. 1992;52:6735–6740. - PubMed
    1. Conteduca V, Sansonno D, Lauletta G, Russi S, Ingravallo G, Dammacco F. H. pylori infection and gastric cancer: state of the art (review) Int J Oncol. 2013;42:5–18. doi: 10.3892/ijo.2012.1701. - DOI - PubMed
    1. Hu B, El Hajj N, Sittler S, Lammert N, Bames R, Meloni-Ehrig A. Gastric cancer: classification, histology and application of molecular pathology. J Gastrointest Oncol. 2012;3:251–261. - PMC - PubMed
    1. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49. doi: 10.1111/apm.1965.64.1.31. - DOI - PubMed

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