Histological Study of Tumour Budding in Colorectal Adenocarcinoma and its Association with Tumor Stage and Nodal Status
Abstract
Introduction: CRC is commonest human carcinoma and leading causes of cancer-related death worldwide. “Tumor budding” is 4 or more tumor cells in invasive front of colorectal adenocarcinoma glands invading up to adjacent stroma, can act as independent prognostic marker for tumor staging which changes prognosis and further treatment plans Objective: Association of tumor budding with stage of tumour and lymph node status. Methods: This is a retrospective study from Jan 2019 – Jan 2022. H&E sections prepared from resected total/hemi/partial colectomy specimens to assess tumor bud count following International tumour budding consensus conference (ITBCC) 2016 criteria “Tumour budding assessed in 1 hotspot (in a field measuring 0.785 mm2) at the invasive front with average 10 consecutive fields with highest bud count in one field (hotspot) under 200x magnifications (field area=0.785 mm2) using Magnus Decahead microscope. The budding was graded as low (0-4 buds), intermediate (5-9 buds), high (10 or more buds). Results: Analysis done according to ITBCC tumor bud scoring shows increased tumor budding is associated with positive higher tumor grade (p value: 0.026) and stage (p value - 0.024) but not with nodal status (p value: 0.096). Conclusion: Current study shows tumor bud score is associated with positive lymph node status, higher tumor grade and stage. However, the study needs to be validated by a larger sample size and follow up studies.References
Lugli A, Kirsch R, Ajioka Y, Bosman F, Cathomas G, Dawson H, El Zimaity H, Fléjou JF, Hansen TP, Hartmann A, Kakar S. Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016. Modern pathology. 2017 Sep;30(9):1299-311.
Mehta A, Goswami M, Sinha R, Dogra A. Histopathological significance and prognostic impact of tumor budding in colorectal cancer. Asian Pacific journal of cancer prevention: APJCP. 2018;19(9):2447.
Mitrovic B, Schaeffer DF, Riddell RH, Kirsch R. Tumor budding in colorectal carcinoma: time to take notice. Modern Pathology. 2012 Oct;25(10):1315-25.
Roy P, Datta J, Roy M, Mallick I, Mohandas M. Reporting of tumor budding in colorectal adenocarcinomas using× 40 objective: A practical approach for resource constrained set-ups. Indian journal of cancer. 2017 Oct 1;54(4):640.
Karamitopoulou E, Zlobec I, Kölzer V, Kondi-Pafiti A, Patsouris ES, Gennatas K, Lugli A. Proposal for a 10-high-power-fields scoring method for the assessment of tumor budding in colorectal cancer. Modern pathology. 2013 Feb;26(2):295-301.
Lino-Silva LS, Salcedo-Hernández RA, Gamboa-Domínguez A. Tumour budding in rectal cancer. A comprehensive review. Contemporary Oncology. 2018;22(2):61.
Gan T, Schaberg KB, He D, Mansour A, Kapoor H, Wang C, Evers BM, Bocklage TJ. Association Between Obesity and Histological Tumor Budding in Patients With Nonmetastatic Colon Cancer. JAMA network open. 2021 Apr 1;4(4):e213897-.
Zlobec I, Bächli M, Galuppini F, Berger MD, Dawson HE, Nagtegaal ID, Lugli A. Refining the ITBCC tumor budding scoring system with a “zero-budding” category in colorectal cancer. Virchows Archiv. 2021 Apr 12:1-6.
Fujiyoshi K, Väyrynen JP, Borowsky J, Papke Jr DJ, Arima K, Haruki K, Kishikawa J, Akimoto N, Ugai T, Lau MC, Gu S. Tumour budding, poorly differentiated clusters, and T-cell response in colorectal cancer. EBioMedicine. 2020 Jul 1;57:102860.
Krištić A, Aralica G, Demirović A, Krušlin B. PATHOHISTOLOGIC PROGNOSTIC AND PREDICTIVE PARAMETERS IN COLORECTAL CANCER-TUMOR BUDDING. Rad Hrvatske Akademije Znanosti i Umjetnosti. Medicinske Znanosti. 2018 Jun 1(45).
Haddad TS, Lugli A, Aherne S, Barresi V, Terris B, Bokhorst JM, Brockmoeller SF, Cuatrecasas M, Simmer F, El-Zimaity H, Fléjou JF. Improving tumor budding reporting in colorectal cancer: a Delphi consensus study. Virchows Archiv. 2021 Mar 1:1-1.
Koelzer VH, Zlobec I, Lugli A. Tumor budding in colorectal cancer—ready for diagnostic practice?. Human pathology. 2016 Jan 1;47(1):4-19.
Cho SJ, Kakar S. Tumor budding in colorectal carcinoma: translating a morphologic score into clinically meaningful results. Archives of pathology & laboratory medicine. 2018 Aug;142(8):952-7.
Demir A, Alan O, Oruc E. Tumor budding for predicting prognosis of resected rectum cancer after neoadjuvant treatment. World journal of surgical oncology. 2019 Dec;17(1):1-8.
Graham RP, Vierkant RA, Tillmans LS, Wang AH, Laird PW, Weisenberger DJ, Lynch CF, French AJ, Slager SL, Raissian Y, Garcia JJ. Tumor budding in colorectal carcinoma: confirmation of prognostic significance and histologic cutoff in a population-based cohort. The American journal of surgical pathology. 2015 Oct;39(10):1340.
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