Sivamayuran Vinothika, Wijesinghe Harshima Disvini, Constantine Roshana, Lokuhetty Menaka Dilani Samarawickrama
Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Int J Surg Pathol. 2025 Apr;33(2):309-317. doi: 10.1177/10668969241260213. Epub 2024 Jul 21.
In contrast to colorectal carcinoma, the significance of tumor budding in breast carcinoma is not established. The X20 objective which is used to assess tumor budding in colorectal carcinoma, is not widely available in countries with limited resources. This study aimed to determine the prevalence of tumor budding and its associations with pathological prognostic factors in invasive breast carcinoma-no special type (IBC-NST), and to assess the correlation between the tumor budding observed using ×20 and ×40 objectives. A total of 349 excision specimens of IBC-NST were studied. Tumor budding was defined as a single cell/cluster of up to 4 cells at the invasive front and was assessed in hotspots at the advancing edge of the tumor using ×20 and ×40 objectives. Tumor budding was categorized into low (<5/0.785 mm), intermediate (5-9/0.785 mm), and high budding (≥10/0.785 mm) for ×20 objective and low (≤4/0.196 mm) and high (≥5/0.196 mm) for ×40 objective based on the number of buds per hotspot. The association between tumor budding and prognostic factors was analyzed with Mann-Whitney test, Kruskal-Wallis test, χ test, and logistic regression. Correlation between tumor budding in ×20 and ×40 objectives was analyzed with Pearson correlation test. The prevalence of tumor budding was 72.5%. There was a significant correlation between the number of buddings observed in ×40 objective and ×20 objective (0.958). High tumor budding observed in both objectives was significantly associated with size ( < .001), lymphovascular invasion ( < .001), perineural invasion ( < .001), lymph node status ( < .001), number of lymph nodes ( < .001), T stage ( < .001), and N stage ( < .001) on univariate analysis, but only lymph node positivity ( < .001) showed significant association on multivariate analysis. Tumor budding assessed with ×20 and ×40 objectives showed a significant correlation and was significantly associated lymph node metastasis on multivariate analysis.
与结直肠癌不同，肿瘤芽生在乳腺癌中的意义尚未明确。用于评估结直肠癌肿瘤芽生的X20物镜，在资源有限的国家并不广泛可用。本研究旨在确定浸润性非特殊类型乳腺癌（IBC-NST）中肿瘤芽生的患病率及其与病理预后因素的关联，并评估使用×20和×40物镜观察到的肿瘤芽生之间的相关性。共研究了349例IBC-NST的切除标本。肿瘤芽生定义为浸润前沿处单个细胞/最多4个细胞的细胞簇，并使用×20和×40物镜在肿瘤前沿的热点区域进行评估。根据每个热点区域的芽生数量，对于×20物镜，肿瘤芽生分为低（<5/0.785 mm）、中（5-9/0.785 mm）和高芽生（≥10/0.785 mm）；对于×40物镜，分为低（≤4/0.196 mm）和高（≥5/0.196 mm）。采用Mann-Whitney检验、Kruskal-Wallis检验、χ检验和逻辑回归分析肿瘤芽生与预后因素之间的关联。采用Pearson相关检验分析×20和×40物镜下肿瘤芽生的相关性。肿瘤芽生的患病率为72.5%。×40物镜和×20物镜观察到的芽生数量之间存在显著相关性（0.958）。单因素分析显示，两种物镜下观察到的高肿瘤芽生均与肿瘤大小（<0.001）、淋巴管侵犯（<0.001）、神经周围侵犯（<0.001）、淋巴结状态（<0.001）、淋巴结数量（<0.001）、T分期（<0.001）和N分期（<0.001）显著相关，但多因素分析显示只有淋巴结阳性（<0.001）具有显著相关性。使用×20和×40物镜评估的肿瘤芽生显示出显著相关性，并且在多因素分析中与淋巴结转移显著相关。
