Department of Hospital Pathology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
Department of Hospital Pathology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Medicina (Kaunas). 2023 Dec 5;59(12):2126. doi: 10.3390/medicina59122126.
Endoscopic resection (ER) is a minimally invasive therapeutic approach for early gastric cancer (EGC), particularly for cases with a low risk of lymph node metastasis (LNM). Tumor budding (TB) has gained attention as a potential prognostic indicator for LNM in EGC. We report two cases-a 73-year-old and an 81-year-old male patient-who presented with gastric adenocarcinoma. Both patients had small-sized, differentiated, and intramucosal adenocarcinomas. However, high-grade TBs per high-power field under ×200 magnification at the invasive front and LNMs were found in both cases. These cases conformed to the post-ER observation guidelines of the current treatment protocol, yet demonstrated LNMs. We found that TB could serve as an effective prognostic marker for LNM compared to traditional risk factors. The aim of this study is to re-examine the ability of TB to predict LNM in EGC, thereby providing an impetus for reconsideration and potential revision of the current treatment guidelines for EGC.
内镜下切除术（ER）是一种治疗早期胃癌（EGC）的微创方法，尤其适用于淋巴结转移（LNM）风险较低的病例。肿瘤芽（TB）作为 EGC 中 LNM 的潜在预后指标受到关注。我们报告了两例 73 岁和 81 岁的男性患者，他们均患有胃腺癌。两名患者均为小尺寸、分化型、黏膜内腺癌。然而，在两位患者的侵袭前沿和 LNM 中，均发现高倍镜下（×200 放大倍数）高等级 TB。这些病例符合当前治疗方案的 ER 后观察指南，但表现出 LNM。我们发现，与传统危险因素相比，TB 可以作为 LNM 的有效预后标志物。本研究旨在重新评估 TB 预测 EGC 中 LNM 的能力，从而为重新考虑和可能修订当前 EGC 治疗指南提供动力。
