Canguçu Augusto Leite, Valério Ediel, Peixoto Roberto Bonfim Pimenta, Felismino Tiago Cordeiro, de Mello Celso Abdon Lopes, Neotti Tatiane, Calsavara Vinicius Fernando, de Macedo Mariana Petaccia, Júnior Samuel Aguiar, Riechelmann Rachel
Department of Clinical Oncology, AC Camargo Cancer Center, Rua Antonio Prudente 211, Sao Paulo, SP CEP: 01509-010, Brazil.
Department of Pathology, AC Camargo Cancer Center, CEP: 01509-010, Brazil.
Ecancermedicalscience. 2020 Oct 29;14:1130. doi: 10.3332/ecancer.2020.1130. eCollection 2020.
Tumour budding (TB) refers to loss of tumour cohesiveness and is defined as isolated cells or a cell cluster of up to four tumour cells at the microscopic analysis. The International Tumour Budding Consensus Conference (ITBCC) in 2016 proposed a scoring system to standardise the pathology evaluation of TB in colorectal cancer (CRC) as high (H), intermediate (I) and low (L) TB.
To evaluate the recurrence-free survival (RFS) of stage II CRC patients as per the ITBCC 2016 classification and associations between TB and clinical pathological features.
Cases of stage II CRC undergoing surgery with available tumour tissue underwent central pathology review for TB. Prognostic factors, retrospectively retrieved from electronic medical charts, were evaluated in univariate and multivariate Cox regression analyses for RFS (primary end point).
Among 137 patients included, L-TB was observed in 107 (78.1%), I-TB in 21 (15.3%) and H-TB in 9 (6.6%). In a median follow-up of 69 months, the median RFS was 134 months, with 14 patients (10.2%) presenting with tumour recurrence: 10 (9.3%) with L-TB, 2 (9.5%) with I-TB and 2 (22.2%) with H-TB. Perineural invasion was more commonly seen in the H-TB group. In multivariate analysis, TB (H and I versus L; HR = 2.6; = 0.059) and not receiving adjuvant chemotherapy (HR 3.7; = 0.020) were independently associated with RFS. Adjuvant chemotherapy was associated longer RFS (HR = 3.7; = 0.022).
In this series of Western patients, TB grade was associated with perineural invasion and increased risk of disease relapse.
肿瘤芽生（TB）是指肿瘤细胞黏附性丧失，在显微镜分析中定义为孤立的细胞或最多由四个肿瘤细胞组成的细胞簇。2016年国际肿瘤芽生共识会议（ITBCC）提出了一种评分系统，以标准化结直肠癌（CRC）中TB的病理评估，分为高（H）、中（I）和低（L）TB。
根据ITBCC 2016分类评估II期CRC患者的无复发生存期（RFS）以及TB与临床病理特征之间的关联。
对接受手术且有可用肿瘤组织的II期CRC病例进行TB的中心病理复查。从电子病历中回顾性检索预后因素，在单因素和多因素Cox回归分析中评估RFS（主要终点）。
在纳入的137例患者中，观察到低TB（L-TB）107例（78.1%），中TB（I-TB）21例（15.3%），高TB（H-TB）9例（6.6%）。中位随访69个月，中位RFS为134个月，14例患者（10.2%）出现肿瘤复发：低TB组10例（9.3%），中TB组2例（9.5%），高TB组2例（22.2%）。神经周围浸润在高TB组中更常见。在多因素分析中，TB（高和中与低相比；HR = 2.6；P = 0.059）和未接受辅助化疗（HR 3.7；P = 0.020）与RFS独立相关。辅助化疗与更长的RFS相关（HR = 3.7；P = 0.022）。
在这一系列西方患者中，TB分级与神经周围浸润和疾病复发风险增加相关。
