Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.
Indian J Med Res. 2019 Dec;150(6):635-639. doi: 10.4103/ijmr.IJMR_1268_17.
BACKGROUND & OBJECTIVES: Tumour budding is a feature of epithelial-to-mesenchymal transformation that is characterized histologically within the tumour stroma by the presence of isolated cells or clusters of less than five cells which are different from the other malignant cells. This could be present around the invasive margin of the tumour, called peritumoural budding, or in the bulk of the tumour, called intratumoural budding. The aim of this study was to assess the predictive power of tumour budding for lymph node metastasis and its relationship with other features of tumour progression in colorectal carcinoma (CRC).
Preoperative colonoscopic biopsies and consecutive resection specimens from 80 patients of colorectal cancer were taken. In the biopsy, intratumoural budding was looked for and graded. In the resection, peritumoural budding was seen and graded along with other features such as grade of the tumour, lymphovascular emboli and tumour border configuration.
Intratumoural budding was seen in 23 per cent (18/80) and peritumoural in 52 per cent (42/80) of cases. Intratumoural budding was associated with the presence of lymphovascular emboli (P=0.002) and irregular tumour border configuration (P=0.004). Peritumoural budding was also significantly associated with the presence of lymphovascular emboli and irregular margins (P < 0.001). Both intra- and peritumoural budding were not associated with the grade of the tumour. Both intra- and peritumoural budding had a significant association with lymph node metastasis (LNM) (P < 0.001).
INTERPRETATION & CONCLUSIONS: Our findings indicate that tumour budding in preoperative biopsy and resection specimens may predict a possibility of finding LNM in patients with CRC.
肿瘤芽殖是上皮间质转化的一个特征，其在肿瘤间质中表现为孤立细胞或少于 5 个细胞的细胞簇，与其他恶性细胞不同。这可能存在于肿瘤的浸润边缘，称为肿瘤周围芽殖，或在肿瘤的大部分中，称为肿瘤内芽殖。本研究旨在评估肿瘤芽殖对淋巴结转移的预测能力及其与结直肠癌（CRC）中肿瘤进展其他特征的关系。
对 80 例结直肠癌患者的术前结肠镜活检和连续切除标本进行了研究。在活检中，寻找并分级肿瘤内芽殖。在切除标本中，观察并分级肿瘤周围芽殖以及其他特征，如肿瘤分级、血管淋巴管侵犯和肿瘤边界形态。
23%（18/80）的病例有肿瘤内芽殖，52%（42/80）的病例有肿瘤周围芽殖。肿瘤内芽殖与血管淋巴管侵犯（P=0.002）和不规则肿瘤边界形态（P=0.004）有关。肿瘤周围芽殖也与血管淋巴管侵犯和不规则边界显著相关（P<0.001）。肿瘤内芽殖和肿瘤周围芽殖均与肿瘤分级无关。肿瘤内芽殖和肿瘤周围芽殖均与淋巴结转移（LNM）显著相关（P<0.001）。
我们的研究结果表明，术前活检和切除标本中的肿瘤芽殖可能预测 CRC 患者发生 LNM 的可能性。
