Kumar Priyadharshini, Vishwanath Meghashree, Selvaraj Saranyabai
Department of Pathology, ACS Medical College and Hospital, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India.
J Midlife Health. 2025 Apr-Jun;16(2):186-191. doi: 10.4103/jmh.jmh_77_25. Epub 2025 Jun 23.
Breast cancer is a leading cause of cancer-related deaths among women worldwide. Prior to metastasis, carcinomas undergo epithelial-mesenchymal transition (EMT), a process wherein cancer cells acquire mobility, form tumor buds (TBs), and invade the stroma. The presence and number of TBs are directly proportional to tumor invasion and metastasis. By scoring TBs and using immunohistochemistry (IHC) to detect EMT process, we can identify patients with poor prognosis after surgical resection. This enables early recognition of patients requiring aggressive treatment and follow-up.
The aim of this study was to propose an algorithm for measuring TB and to establish the correlation between TB with EMT markers expression and main clinical parameters.
A retrospective analytical study in an urban tertiary health care center involving 47 cases of invasive breast carcinomas. TB was assessed in Haematoxylin & Eosin stained tissue sections followed by IHC with EMT markers. Association between TB, EMT markers, and main clinical parameters was statistically analyzed using the Chi-square test.
Among 47 cases, 30 had mean-low TB score (≤4/ 10HPF) and 17 had mean-high TB score (>4/10 HPF). Tumors with high TB scoring showed strong SNAIL, TWIST, and N-cadherin expression. Tumors with low TB scores showed high E-cadherin expression and low SNAIL, TWIST, and N-cadherin expression.
The study established a positive correlation between TB and EMT markers. High TB scores are significantly associated with lymphovascular invasion, lymph node metastasis, and higher tumor grading. Using TB score and EMT markers in breast cancer management can facilitate patient-centered approach.
乳腺癌是全球女性癌症相关死亡的主要原因。在转移之前，癌细胞会经历上皮-间质转化（EMT），在此过程中癌细胞获得迁移能力，形成肿瘤芽（TBs）并侵入基质。肿瘤芽的存在和数量与肿瘤侵袭和转移成正比。通过对肿瘤芽进行评分并使用免疫组织化学（IHC）检测EMT过程，我们可以识别手术切除后预后不良的患者。这有助于早期识别需要积极治疗和随访的患者。
本研究的目的是提出一种测量肿瘤芽的算法，并建立肿瘤芽与EMT标志物表达及主要临床参数之间的相关性。
在一家城市三级医疗保健中心进行的回顾性分析研究，涉及47例浸润性乳腺癌病例。在苏木精和伊红染色的组织切片中评估肿瘤芽，随后用EMT标志物进行免疫组织化学检测。使用卡方检验对肿瘤芽、EMT标志物和主要临床参数之间的关联进行统计学分析。
在47例病例中，30例的肿瘤芽评分中等偏低（≤4/10高倍视野），17例的肿瘤芽评分中等偏高（>4/10高倍视野）。肿瘤芽评分高的肿瘤显示出强烈的SNAIL、TWIST和N-钙黏蛋白表达。肿瘤芽评分低的肿瘤显示出高E-钙黏蛋白表达以及低SNAIL、TWIST和N-钙黏蛋白表达。
该研究建立了肿瘤芽与EMT标志物之间的正相关。高肿瘤芽评分与淋巴管侵犯、淋巴结转移和更高的肿瘤分级显著相关。在乳腺癌管理中使用肿瘤芽评分和EMT标志物可以促进以患者为中心的治疗方法。
