Clinicopathological Study of Poorly Differentiated and Signet-ring Cell Carcinoma of the Colon and Rectum

Ichiro Hirai, Eiichi Ikeda, Hajime Iizawa, Toshihiko Sato, Kenji Okabe, Takuya Ishida, Youichi Ohta

Department of Surgery, Yamagata Prefectural Central Hospital

During the past 11 years, a total of 1260 patients with colorectal carcinoma underwent surgery at our department. Histological examination revealed that 93 patients had poorly differentiated adenocarcinoma (por) and 7 had signet-ring cell carcinoma (sig). Regarding the clinical aspects, early diagnosis was rarely made in patients with either por or sig. Por and sig tumors thought to have a rapid growth. Five-year survival rates in patients with well, moderate and poorly differentiated carcinoma, including sig, were 67.9%, 42.3% and 37.4%, respectively. In this study, a further histological classification of por and sig was applied so that the unfavorable prognosis could be analyzed. clinicopathologically. The medullary type of por had a 5-year survival rate of 79.6% after surgery, while no patient with the scirrhous type survived more than three years. An interesting suggestion of this study was that the medually and scirrhous types of por were revealed to have a smaller proportion of highly differentiated structure as compared with the intermediate type. It was presumed that the development of por, at least the medullary and scirrhous types, might be achieved without the early stage of differentiated carcinoma from the beginning of carcinogenesis. In conclusion, classification of por according to fibrous stroma would play an important role in the clinical study of colorectal carcinoma.

Key words
poorly differentiated adennocarcinoma of colon and rectum, signet-ring cell carcinoma of colon and rectum, fibrous stroma, prognosis of colorectal carcinoma

Reprint requests
Ichiro Hirai Department of Surgery, Yamagata Prefectural Central Hospital
7-17 Sakura-cho, Yamagata, 990 JAPAN

Accepted
January 11, 1995

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