Author commentary on Lianlian Wu et al.

Lianlian Wu et al. Clinical decision tree for optimizing endoscopic assessment of signet ring cell carcinoma in hereditary diffuse gastric cancer surveillance

The endoscopic Cambridge criteria for recognition of early signet ring cell carcinoma (SRCC) were retrospectively evaluated in 147 individuals with hereditary diffuse gastric cancer syndrome. Machine-learning models were then used to develop a clinical decision tree (cDT) for application of the criteria. In a subsequent prospective validation study in 66 CDH1 pathogenic-variant carriers, the cDT showed 77.8 % (21/27) sensitivity and 90.7 % (49/54) specificity, and improved the diagnostic performance of both experts and non-experts.

Publication History

Article published online:
24 September 2025