Evaluation of tumor budding and its correlation with histomorphological prognostic markers in oral squamous cell carcinoma and its association with the epithelial-mesenchymal transition process

Abstract

Objective: To evaluate the association of tumor budding (TB) with prognostic histomorphological parameters in oral squamous cell carcinoma (OSCC) and to investigate the correlation of TB intensity with epithelial to mesenchymal transition (EMT). Material and Method: A total of 200 cases diagnosed as OSCC were selected and their TB status was reviewed using Hematoxylin and eosin (H and E) and Immunohistochemistry (IHC). Correlation with histomorphological prognostic parameters was done. Also, IHC for Vimentin and E-cadherin was performed to look for EMT. Results: On H and E examination, TB was observed in 154/200 (77%). About 88/154 (57.14%) cases showed a high TB (>5 TB/10 hpf) which increased to 100/154 (64.9%) cases on IHC staining. The intensity of TB was significantly associated with tumor grade and depth of invasion. It was also significantly associated with reduced expression for E-Cadherin and upregulation of Vimentin establishing a pathogenetic correlation between the TB and EMT. Conclusion: Therefore, our results suggest that TB is associated with poor prognosis and histologically represents EMT in OSCC which further adds to the aggressiveness of the tumor.

Tumor budding to investigate local invasion, metastasis, and prognosis of head and neck carcinoma: A systematic review

“…Among the 36 studies included in the qualitative analysis, 35 had an observational retrospective design and were ex vivo tissue investigations based on histopathological analysis of biopsies or surgical specimens, 25,30–32,33–64 while only 1 study had a prospective design 33 . These studies were published between 2010 and 2023.…”

“…The median number of patients per study was 150 (range 53–254 cases). Histopathological analysis was based on biopsies in 4 studies (11.1%), 38,45–47 on surgical specimens in 30 (83.3%), 30–33,35–37,39–43,48–64 and mixed bioptic samples/surgical specimens in 2 (5.55%) 34,44 …”

“…No records were unavailable for retrieving. Finally, 36 were included in the review 25,30–64 . A detailed flowchart of the search process is shown in Figure 1.…”

“…For OSCCs with higher TB scores, the existing literature agrees in describing significantly less favorable outcomes compared to those with lower TB, in terms of OS, 48,[57][58][59][60][62][63][64] disease-specific survival (DSS), 30,39 and diseasefree survival (DFS). 33,42,48,55,57,63 The summary of findings of the included studies has been reported in Table 1.…”

“…The median number of patients per study was 150 (range 53-254 cases). Histopathological analysis was based on biopsies in 4 studies (11.1%), 38,[45][46][47] on surgical specimens in 30 (83.3%), [30][31][32][33][35][36][37][39][40][41][42][43][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] and mixed bioptic samples/surgical specimens in 2 (5.55%). 34,44 Major findings of the retrieved articles are discussed in dedicated paragraphs of section 4.…”