Puccio Sebastiano, Azzarello Giuseppe, Maffeis Valeria, Laurino Licia, Mairani Edoardo, Conte Federica, Tessari Nicola, Cazzador Diego, Zanoletti Elisabetta, Politi Doriano, Emanuelli Enzo, Spinato Giacomo, Ausoni Simonetta
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, "Azienda Ospedale Università di Padova" University of Padova, via Giustiniani, 2, 35122 Padova, Italy.
Department of Oncology, Local Health Unit 3 Serenissima, Via don Giacobbe Sartor 4, 30035 Venice, Italy.
Cancers (Basel). 2024 May 16;16(10):1895. doi: 10.3390/cancers16101895.
Sinonasal intestinal-type adenocarcinoma (ITAC) is a very rare, closely occupational-related tumor with strong histological similarities to colorectal cancer (CRC). In the latter, tumor budding (TB) is widely recognized as a negative prognostic parameter. The aim of this study was to evaluate the prognostic role of TB in ITAC and to correlate it with other established or emerging biomarkers of the disease, such as p53 and deficient DNA mismatch repair (MMR) system status/microsatellite instability (MSI). We retrospectively analyzed 32 consecutive specimens of patients with ITAC diagnosis treated in two institutions in Northern Italy. We reviewed surgical specimens for TB evaluation (low-intermediate/high); p53 expression and MMR proteins were evaluated via immunohistochemistry. Results were retrospectively stratified using clinical data and patients' outcomes. According to bud counts, patients were stratified into two groups: intermediate/high budding (>4 TB) and low budding (≤4 TB). Patients with high TB (>4) have an increased risk of recurrence and death compared to those with low TB, with a median survival of 13 and 54 months, respectively. On multivariate analysis, considering TB, therapy, and stage as covariates, TB emerged as an independent prognostic factor net of the stage of disease or type of therapy received. No impact of p53 status as a biomarker of prognosis was observed and no alterations regarding MMR proteins were identified. The results of the present work provide further significant evidence on the prognostic role of TB in ITAC and underline the need for larger multicenter studies to implement the use of TB in clinical practice.
鼻窦肠型腺癌（ITAC）是一种非常罕见的、与职业密切相关的肿瘤，在组织学上与结直肠癌（CRC）有很强的相似性。在结直肠癌中，肿瘤芽生（TB）被广泛认为是一个不良预后参数。本研究的目的是评估TB在ITAC中的预后作用，并将其与该疾病的其他已确立或新出现的生物标志物，如p53和DNA错配修复（MMR）系统缺陷/微卫星不稳定性（MSI）相关联。我们回顾性分析了意大利北部两家机构治疗的32例连续诊断为ITAC的患者的标本。我们检查手术标本以评估TB（低-中/高）；通过免疫组织化学评估p53表达和MMR蛋白。结果根据临床数据和患者结局进行回顾性分层。根据芽计数，患者被分为两组：中/高芽生（>4个TB）和低芽生（≤4个TB）。高TB（>4）的患者与低TB患者相比，复发和死亡风险增加，中位生存期分别为13个月和54个月。在多变量分析中，将TB、治疗和分期作为协变量，TB成为独立于疾病分期或所接受治疗类型的预后因素。未观察到p53状态作为预后生物标志物的影响，也未发现MMR蛋白有改变。本研究结果为TB在ITAC中的预后作用提供了进一步的重要证据，并强调需要进行更大规模的多中心研究，以在临床实践中应用TB。
