Department of Surgery, Galway University Hospital, Galway, Ireland.
Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
Breast Cancer Res Treat. 2020 Oct;183(3):503-514. doi: 10.1007/s10549-020-05810-3. Epub 2020 Jul 24.
Tumour budding (TB) is an adverse histological feature in many epithelial cancers. It is thought to represent epithelial-mesenchymal transition, a key step in the metastatic process. The significance of TB in breast carcinoma (BC) remains unclear. The aim of this study is to investigate the relationship between TB and other histological and molecular features of BC.
A systematic search was performed to identify studies that compared features of BC based on the presence or absence of high-grade TB. Dichotomous variables were pooled as odds ratios (OR) using the Der Simonian-Laird method. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale (NOS).
Seven studies with a total of 1040 patients (high-grade TB n = 519, 49.9%; low-grade/absent TB n = 521, 50.1%) were included. A moderate to high risk of bias was noted. The median NOS was 7 (range 6-8). High-grade TB was significantly associated with lymph node metastasis (OR 2.32, 95% c.i. 1.77 to 3.03, P < 0.001) and lymphovascular invasion (OR 3.08, 95% c.i. 2.13 to 4.47, P < 0.001). With regard to molecular subtypes, there was an increased likelihood of high-grade TB in oestrogen (OR 1.66, 95% c.i. 1.21 to 2.29, P = 0.002) and progesterone receptor-positive (OR 1.48, 95% c.i. 1.09 to 2.02, P = 0.01) tumours. In contrast, triple-negative breast cancer had a reduced incidence of high-grade TB (OR 0.46, 95% c.i. 0.30 to 0.72, P = 0.0006).
High-grade TB is enriched in hormone receptor-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic process of BC.
肿瘤芽（TB）是许多上皮癌的不良组织学特征。它被认为代表上皮-间充质转化，这是转移过程中的关键步骤。TB 在乳腺癌（BC）中的意义尚不清楚。本研究旨在探讨 TB 与 BC 的其他组织学和分子特征之间的关系。
系统检索以确定比较基于高分级 TB 存在与否的 BC 特征的研究。使用 Der Simonian-Laird 方法将二项变量汇总为优势比（OR）。使用纽卡斯尔-渥太华量表（NOS）对纳入研究进行质量评估。
纳入了 7 项共 1040 例患者的研究（高分级 TB 组 n=519，49.9%；低分级/无 TB 组 n=521，50.1%）。存在中度至高度偏倚风险。NOS 的中位数为 7（范围 6-8）。高分级 TB 与淋巴结转移（OR 2.32，95%置信区间 1.77 至 3.03，P<0.001）和淋巴管侵犯（OR 3.08，95%置信区间 2.13 至 4.47，P<0.001）显著相关。关于分子亚型，高分级 TB 在雌激素受体（OR 1.66，95%置信区间 1.21 至 2.29，P=0.002）和孕激素受体阳性（OR 1.48，95%置信区间 1.09 至 2.02，P=0.01）肿瘤中更常见。相反，三阴性乳腺癌的高分级 TB 发生率较低（OR 0.46，95%置信区间 0.30 至 0.72，P=0.0006）。
高分级 TB 在激素受体阳性 BC 中更为丰富，与已知的不良预后变量相关。TB 可能为 BC 的转移过程提供新的见解。
