Tumor budding as a new histological parameter in the metastasis of colorectal cancer

Abstract

Introduction:The presence of tumor budding, i.e.,single cancer cells or a nest of poorly differentiated cells at the front of tumor invasion appears to be a new histopathological indicator of increased aggressiveness of colorectal carcinoma. Purpose: The aim of this work was a retrospective evaluation of the invasion front (tumorbudding, vascular invasion,and lymphocytic infiltration) in postoperative biopsies of patients with colorectal carcinoma and analysis of the 5-year survival. Materialsand methods:The study was based on the material received after surgical treatment of 164 patients with colon cancer. Tissue was obtained directly following tumor resection, fixed in 10% formaldehyde and embedded in paraffin blocks using a routine method by melting with paraffin at a temperature of 56º C. These samples were then routinely stained with haematoxylin and eosin and underwent a histopathological evaluation, with particular attention being paid to the invasion front of the tumor. The immunohistochemical expression of cytokeratin 20 was also evaluated using anti-human CK20 monoclonal antibody (clone Ks.20.8, Dako, Poland). Results: Tumor budding was found in 124 out of 164 patients. Statistical analysis showed a correlation between the presence of tumor budding TB and depth of invasion (pT), lymph node metastasis, distant metastasis, lymphocytic infiltration,and vascular invasion. The cumulative five-year survival correlated with the lack of tumor budding and vascular invasion, as well as a decrease in lymphocyticinfiltration.

Immunohistochemical Expression of “HCG-β” in Colorectal Carcinoma

“…In the current study, lymph node status (N) was statistically significantly correlated with tumor budding (p = 0.009), which was consistent with the results of El (p = 0.001, 0.006, 0.000, <0.001, and <0.0001, respectively) [5], [15], [22], [23], [24]. This relationship points to the role of tumor budding in EMT and as precedent step to vascular invasion.…”

“…This is mostly attributed to less tendency of malignant cells to form glands and higher dis-cohesion in high grade tumors. The same findings yet with statistically insignificant correlations were reported by Konishi et al, 2018 andUstymowicz, 2018 studies (p = 0.064 and 0.458, respectively) [5], [22].…”

“…Regarding local tumor invasiveness (T) in this study, higher rate of tumor budding was present in T3-T4 cases and absent in T1-T2 cases but this results were statistically insignificant (p = 0.925), similar to results reported by Konishi et al, 2018 study (p = 0.091) [5]. On the other hand, statistically significant correlation was reported by Ustymowicz, 2018;Şirin et al, 2019 andDawson et al, 2019, studies between T and tumor budding (p = 0.001, 0.002 and <0.0001, respectively) [15], [22], [23].…”