Tumor budding – A promising prognostic histopathological parameter in oral squamous cell carcinoma – A comparative immunohistochemical study

Prognostic significance of tumor budding thresholds in oral tongue squamous cell carcinoma

“…Our results confirm the prognostic value of TB in OTSCC, and the two‐tier system with a cutoff of 5 buds/field is highly predictive of LNM and DSS, regardless the pathological Stage. This cutoff is the most reported in the literature (Almangush et al, 2014, 2015, 2018; Attramadal et al, 2015; Joshi et al, 2020; Leao et al, 2017; Marangon Junior et al, 2014, 2018, 2019; Pedersen et al, 2017; Seki‐Soda et al, 2019; Wang et al, 2011; Xie et al, 2015; Xu et al, 2021), compared with 3 buds/field (Chatterjee et al, 2019; Hong et al, 2018; Seki et al, 2016) and to 10 buds/field (Ebihara et al, 2019; Manjula et al, 2015; Shimizu et al, 2018; Sowmya et al, 2020; Xie et al, 2015). Although the three‐tier system further improve the risk stratification, our results do not show significant differences between high and intermediate‐risk group.…”

“…Furthermore, single bud cells could be confused with the adjacent tumoral stroma (Kale & Angadi, 2019; Zlobec & Lugli, 2010). So, a cytokeratin immunostaining would allow a better visualization, showing the limits of neoplastic epithelial cells (Joshi et al, 2020; Wang et al, 2011; Xie et al, 2015, 2019); although, the IHC may also stain apoptotic bodies and cellular debris, which should not be counted (Wang et al, 2011). Finally, the IHC showed a better reproducibility compared to the HE, resulting more easier, regardless the examiners experience (Joshi et al, 2020; Kale & Angadi, 2019; Leao et al, 2017; Sakata et al, 2018).…”

“…So, a cytokeratin immunostaining would allow a better visualization, showing the limits of neoplastic epithelial cells (Joshi et al, 2020; Wang et al, 2011; Xie et al, 2015, 2019); although, the IHC may also stain apoptotic bodies and cellular debris, which should not be counted (Wang et al, 2011). Finally, the IHC showed a better reproducibility compared to the HE, resulting more easier, regardless the examiners experience (Joshi et al, 2020; Kale & Angadi, 2019; Leao et al, 2017; Sakata et al, 2018). However, the ITBCC recommendations have been validated as a reliable and simple scoring method in early and/or advanced OTSCC (Xie et al, 2015).…”

“…However, TB could be obscured by the peritumoral infiltrate, reactive stromal cells, and glandular fragmentation. Moreover, its assessment could be difficult in poorly differentiate OSCC, because of bud cells are surrounded by many lymphocytes, cancer-associated fibroblasts and other stromal cells (Joshi et al, 2020;Wang et al, 2011;Xie et al, 2015Xie et al, , 2019. Furthermore, single bud cells could be confused with the adjacent tumoral stroma (Kale & Angadi, 2019;Zlobec & Lugli, 2010).…”

“…Furthermore, single bud cells could be confused with the adjacent tumoral stroma (Kale & Angadi, 2019;Zlobec & Lugli, 2010). So, a cytokeratin immunostaining would allow a better visualization, showing the limits of neoplastic epithelial cells (Joshi et al, 2020;Wang et al, 2011;Xie et al, 2015Xie et al, , 2019;…”