![]() If neoplastic cells with SRC morphology predominate in the tumour, the tumour is defined as SRC carcinoma. The 2010 WHO classification defines PC tumours as GC composed of isolated or small groups of tumour cells. One of the main reasons for these inconsistent findings over the relationship between SRC and prognosis appears to be a lack of standardization of GC histological subtype definitions. More recently, some comparative studies from Western and Asian authors suggested that the prognostic impact of SRC histology depends on the stage of the disease, being favourable in early stages but adverse in advanced tumour stages. While some authors report a relationship between SRC histology and poor prognosis, other studies have not confirmed this finding. Ĭonflicting data exist about the prognostic relevance of SRC histology. Evidence has accumulated over the last decades that clinicopathological characteristics of GC are changing, especially in the West with a decreasing incidence of distal, intestinal type tumours and the corresponding increasing proportion of tumours with Laurén diffuse or WHO poorly cohesive (PC) including signet ring cell (SRC) histology. As such, this consensus classification would allow the generation of evidence on biological and prognostic differences between these GC subtypes.ĭespite a declining incidence, gastric cancer (GC) is still one of the major causes of cancer death worldwide. The reported statements clarify some debated topics on pathological classifications used for PC and SRC GC. All other PC non-SRC types have to be further subdivided into PC carcinomas with SRC component ( 10% SRCs) and PC carcinomas not otherwise specified (< 10% SRCs). Moreover, to standardize the definition of SRC carcinomas, the proposal that only WHO PC carcinomas with more than 90% poorly cohesive cells having signet ring cell morphology have to be classified as SRC carcinomas was made. ResultsĪ consensus was reached on the need to classify gastric carcinoma according to the most recent edition of the WHO classification which is currently WHO 2010. Then, through a Delphi method, consensus statements for each topic were elaborated. The topics were debated during a dedicated Workshop held in Verona in March 2017. MethodsĪ multidisciplinary expert team belonging to the European Chapter of International Gastric Cancer Association (IGCA) identified 11 topics on pathological classifications used for PC and SRC GC. To accurately assess the behaviour and the prognosis of these GC subtypes, the standardization of pathological definitions is needed. Clinicopathological characteristics of gastric cancer (GC) are changing, especially in the West with a decreasing incidence of distal, intestinal-type tumours and the corresponding increasing proportion of tumours with Laurén diffuse or WHO poorly cohesive (PC) including signet ring cell (SRC) histology.
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