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.
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24 September 2025
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