Santos Emily Karoline Araujo Nonato Dos, Triches Bruna Gama, Silva Guilherme Prestes da, Linhares Julia Costa, Mehanna Samya Hamad, Cavalcanti Marcela Santos
Faculdade Evangélica Mackenzie do Paraná, Medical Course - Curitiba (PR), Brazil.
Faculdade Pequeno Príncipe, Medical Course - Curitiba (PR), Brazil.
Arq Bras Cir Dig. 2025 Apr 7;38:e1875. doi: 10.1590/0102-6720202500006e1875. eCollection 2025.
Microscopic analysis of tumor budding (TB) may be an essential predictive tool for regional lymph node metastases in colorectal cancer, especially among patients in intermediate stages, who exhibit considerable prognostic variability.
The aim of this study was to assess the predictive power of BT regarding the presence of lymph node metastases and its association with other characteristics related to colorectal carcinoma progression.
This is a cross-sectional, retrospective study with a quantitative approach, focusing on the review of medical records and histopathological reports of patients who underwent oncologic surgery for colorectal cancer.
A total of 153 patient records were examined, with a predominance of the 61-70 age group and a male majority (50.98%). Adenocarcinoma not otherwise specified was the most common histological type (60.78%), with the majority exhibiting moderate differentiation (87.58%). From the total sample, 97 cases (63.39%) exhibited TB, with 51.55% classified as a high budding score. Invasion of adipose tissue/subserosa was the most prevalent, occurring in 46.41% of cases. Regional lymph node metastases and angiolymphatic invasion were observed in 66 and 101 patients, respectively. Cross-tabulation analysis showed a statistically significant association between TB and lymph node metastasis (p<0.05).
The relationship between TB and lymph node metastasis highlights the significance of this histological factor in the risk stratification and prognosis of patients with colorectal cancer, complementing TNM staging. Therefore, the assessment of tumor budding is crucial in histopathological reports, potentially influencing additional therapeutic decisions.
肿瘤芽生（TB）的显微镜分析可能是预测结直肠癌区域淋巴结转移的重要工具，尤其是在预后差异较大的中期患者中。
本研究旨在评估肿瘤芽生对于淋巴结转移的预测能力及其与结直肠癌进展相关的其他特征的关联。
这是一项采用定量方法的横断面回顾性研究，重点是对接受结直肠癌肿瘤手术患者的病历和组织病理学报告进行回顾。
共检查了153份患者记录，以61 - 70岁年龄组为主，男性占多数（50.98%）。未另行指定的腺癌是最常见的组织学类型（60.78%），大多数表现为中度分化（87.58%）。在总样本中，97例（63.39%）表现出肿瘤芽生，其中51.55%被归类为高芽生评分。脂肪组织/浆膜下侵犯最为常见，发生在46.41%的病例中。分别在66例和101例患者中观察到区域淋巴结转移和血管淋巴管侵犯。交叉表分析显示肿瘤芽生与淋巴结转移之间存在统计学显著关联（p<0.05）。
肿瘤芽生与淋巴结转移之间的关系突出了这一组织学因素在结直肠癌患者风险分层和预后中的重要性，补充了TNM分期。因此，在组织病理学报告中评估肿瘤芽生至关重要，可能会影响额外的治疗决策。
