Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008, Switzerland.
Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008, Switzerland.
Eur J Cancer. 2020 May;130:139-145. doi: 10.1016/j.ejca.2020.02.007. Epub 2020 Mar 19.
Tumour grade is traditionally considered in the management of patients with colorectal cancer. However, a large body of literature suggests that a related feature, namely tumour budding, may have a more important clinical impact. The aim of our study is to determine the correlation between tumour grade and tumour budding and their impact on patient outcome.
A retrospective collective of 771 patients with colorectal cancer were included in the study. Clinicopathological information included tumour grade (World Health Organisation 2010; G1, G2 and G3) and tumour budding evaluated as BD1, BD2 and BD3 and representing 0-4 buds, 5-9 buds and 10 or more buds per 0.785 mm, respectively.
Tumour grade and tumour budding were correlated (p < 0.0001, percent concordance: 33.8%). Of the BD1 cases, 18.1% were of G3. Only two BD3 cases were G1. Both high tumour grade and tumour budding were associated with higher pT, lymph node metastasis, distant metastasis and lymphatic and venous vessel invasion (p < 0.01, all), but only tumour grade was additionally associated with right-sided tumour location and mucinous histology. Higher tumour budding led to worse overall (p = 0.0286) and disease-free survival (p = 0.001), but tumour grade did not. Budding was independent of tumour grade in multivariate analysis.
Tumour grade and tumour budding are distinct features, as recognised by their different clinicopathological associations, reflecting different underlying biological processes. Nonetheless, tumour budding seems to outperform tumour grade in terms of predicting disease-free survival.
肿瘤分级在结直肠癌患者的治疗中一直被认为是传统的考虑因素。然而，大量文献表明，一个相关的特征，即肿瘤芽殖，可能具有更重要的临床影响。我们的研究目的是确定肿瘤分级和肿瘤芽殖之间的相关性及其对患者预后的影响。
本研究回顾性收集了 771 例结直肠癌患者的临床病理资料。包括肿瘤分级（世界卫生组织 2010 年；G1、G2 和 G3）和肿瘤芽殖，评估为 BD1、BD2 和 BD3，分别代表 0-4 个芽、5-9 个芽和 10 个或更多芽/0.785mm。
肿瘤分级和肿瘤芽殖之间存在相关性（p<0.0001，一致性百分比：33.8%）。BD1 病例中，G3 占 18.1%。仅 2 例 BD3 为 G1。高肿瘤分级和肿瘤芽殖均与更高的 pT、淋巴结转移、远处转移以及淋巴管和静脉侵犯相关（p<0.01，均），但只有肿瘤分级与肿瘤位于右侧和黏液组织学相关。较高的肿瘤芽殖导致总体生存率（p=0.0286）和无病生存率（p=0.001）更差，但肿瘤分级则没有。在多变量分析中，芽殖独立于肿瘤分级。
肿瘤分级和肿瘤芽殖是不同的特征，其不同的临床病理相关性表明它们反映了不同的潜在生物学过程。尽管如此，在预测无病生存率方面，肿瘤芽殖似乎优于肿瘤分级。
