Argon Asuman, Öz Özden, Kebat Tulu Ayata
Department of Pathology, Izmir Faculty of Medicine, University of Health Sciences, İzmir, Turkey.
Department of Pathology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir, Turkey.
Indian J Pathol Microbiol. 2023 Jan-Mar;66(1):38-43. doi: 10.4103/ijpm.ijpm_905_21.
In this study, it was aimed to investigate the prognostic importance of Tumor budding (TB) in Pancreatic ductal adenocarcinomas(PDAC) and its correlation with histopathological findings according to the International Tumor Budding Consensus Conference(ITBCC) grading.
A total of 75 patients diagnosed with PDAC were included in this study. The demographic features of the cases (age, sex) and the macroscopic features of the tumors (localization,size) were obtained from the electronic archive system. All Hematoxylin-Eosin-stained sections were re-evaluated in terms of differentiation, presence of lymphovascular (LVI) and perineural invasion(PNI), surgical margin positivity, primary tumor(pT), lymph node metastasis(LNM) and tumor budding. Statistically, Chi-square test, cox-regression and Kaplan-Meier test were performed.
Thirty four of the cases were female and 41 were male. The mean age was 64.21±9.71years. The degree of TB was TB-few in 17 cases, TB-moderate in 25cases, and TB-high in 33cases. LVI, PNI, LNM and TB-high were poor prognostic factors. Moreover, TB-high was related with poor differantiation,LVI,PNI,LNM and short survival time. Tumor budding was independent negative prognostic factor in multivariable model analyzes.
ITBCC scoring can also be used in PDACs. In addition, high tumor budding was a poor prognostic feature and might be a target for tumor-specific treatments as it could be a predictive finding for the locally invasive character of the tumor. Evaluation and grading of TB thought to represent EMT may be a histological feature that can be used in tumor selection for advanced molecular methods to identify subtypes that may be associated with poor prognosis and drug resistance.
本研究旨在根据国际肿瘤芽生共识会议（ITBCC）分级，探讨肿瘤芽生（TB）在胰腺导管腺癌（PDAC）中的预后重要性及其与组织病理学结果的相关性。
本研究共纳入75例诊断为PDAC的患者。病例的人口统计学特征（年龄、性别）和肿瘤的宏观特征（定位、大小）从电子存档系统中获取。对所有苏木精-伊红染色切片进行重新评估，内容包括分化程度、淋巴管浸润（LVI）和神经周围浸润（PNI）、手术切缘阳性情况、原发肿瘤（pT）、淋巴结转移（LNM）和肿瘤芽生。统计学上，进行卡方检验、cox回归分析和Kaplan-Meier检验。
34例为女性，41例为男性。平均年龄为64.21±9.71岁。TB程度为少量芽生的有17例，中度芽生的有25例，高度芽生的有33例。LVI、PNI、LNM和高度芽生是不良预后因素。此外，高度芽生与低分化、LVI、PNI、LNM及较短生存时间相关。在多变量模型分析中，肿瘤芽生是独立的阴性预后因素。
ITBCC评分也可用于PDAC。此外，高肿瘤芽生是不良预后特征，可能是肿瘤特异性治疗的靶点，因为它可能是肿瘤局部侵袭性的预测指标。认为代表上皮-间质转化（EMT）的TB评估和分级可能是一种组织学特征，可用于肿瘤选择，以便采用先进的分子方法识别可能与不良预后和耐药性相关的亚型。
