Impact of Alcian blue and periodic acid Schiff expression on the prognosis of gastric signet ring cell carcinoma  

作　　者：Juan Lin Zhu-Feng Chen Guo-Dong Guo Xin Chen 

机构地区：[1]Shengli Clinical Medical College,Fujian Medical University,Fuzhou 350001,Fujian Province,China [2]Department of Pathology,Fujian Provincial Hospital,Fuzhou 350001,Fujian Province,China [3]Department of Internal Medicine,Fujian Provincial Hospital,Fuzhou 350001,Fujian Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第3期687-698,共12页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：the Startup Fund for Scientific Research of Fujian Medical University,No.2020QH1170.

摘　　要：BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and neutral mucus,respectively.However,the clinical importance of the special combined AB and PAS stain is unclear.AIM To investigate AB expression,PAS expression and the AB-to-PAS(A/P)ratio in gastric SRCC patients and to assess patient prognosis.METHODS Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS,and signet ring cell positivity was assessed quantitatively.Immuno-histochemical staining for Ki67,protein 53(P53)and human epidermal growth factor receptor 2(HER2)was performed simultaneously.The cancer-specific survival(CSS)rate was estimated via Kaplan-Meier analysis.Cox proportional hazards models were used for univariate and multivariate survival analyses.RESULTS Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup(P<0.001).The 3-year CSS rate in the A/P≤0.5 group was significantly greater than that in the A/P>0.5 group(P=0.042).Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter,lymph node metastasis,vessel carcinoma embolus,tumor stage,the A/P ratio and the expression of Ki67,P53 and the PAS.Cox multivariate regression analysis confirmed that low PAS expression[hazard ratio(HR)=3.809,95%confidence interval(CI):1.563-9.283,P=0.003]and large tumor diameter(HR=2.761,95%CI:1.086-7.020,P=0.033)were independent risk factors for poor prognosis.CONCLUSION A/P>0.5 is potentially a risk factor for prognosis,and low PAS expression is an independent risk factor in the prognosis of gastric SRCC.PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.

关 键 词：Alcian blue Periodic acid-Schiff PROGNOSIS GASTRIC Signet ring cell carcinoma 

分 类 号：R735.2[医药卫生—肿瘤]