Tumor budding in cervical carcinoma: Associations with some clinical and pathological factors

Nevena Stanulovic,Aljosa Mandic,Bojana Gutic,Tatjana Ivkovic-Kapicl

doi:10.2298/aoo200124003s

Nevena Stanulovic, Aljosa Mandic + Show 2 more

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https://doi.org/10.2298/aoo200124003s

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Abstract

Background: Tumor budding is recognized as an important independent prognostic factor in colorectal carcinoma. The aim of this study was to evaluate the grade of tumor budding and association with other clinical and pathological features in patients with cervical carcinoma. Material and methods: We evaluated pathohistological data from 91 cervical carcinoma patients (mean age: 53.8 years) who underwent radical hysterectomy and pelvic lymphatic dissection at the Oncology Institute of Vojvodina between January 2010 and December 2018. Tumor budding was evaluated in invasive front of the tumor. Based on the number of bud counts/10 high power field, three groups were formed: with no budding, with less than 15 buds, and with more than 15 buds. Results: Eighty (87.91%) of evaluated cervical carcinomas were squamous-cell type, while 12.09% were adenocarcinomas. All carcinomas were graded (HG1-HG3). Average diameter of the tumors was 25 mm (81.6% < 4 cm and 18.4% > 4 cm). Metastases in lymph nodes were present in 30 (32.9%) cases. Based on the number of bud counts/10 high power field there were 35.1% with no budding, 32.9% with less than 15 buds and 37.3% with more than 15 buds. There was a significant association between tumor budding grade and histological grade (p=0.04), as well as with tumor budding grade and the diameter of the tumor (p=0.04). Conclusion: As a quantitative measure of cancer cell dissociation, tumor budding is associated with poor prognosis in cervical carcinoma and should be considered as a prognostic factor.

Highlights

Cervical cancer is a main cause of cancer-related deaths in women in low-income countries [1]
These results showed that 55.88% of patients with tumor budding grade 3 had moderately differentiated carcinoma and 44.11% of them had a poorly differentiated one
Our results showed that none of the well differentiated cervical carcinomas had high tumor budding grade

Summary

Introduction

Cervical cancer is a main cause of cancer-related deaths in women in low-income countries [1]. The histologic grade of cervical carcinoma is, primarily based on keratinization, cytological features, mitotic activity, as well as pattern of invasion [7,8,9,10]. These studies have not affirmed the prognostic significance of any proposed grading systems. The latest one, 3-stage scoring system of infiltrative growth of cervical carcinoma was proposed with: closed, finger- and spray-like pattern of invasion (Figure 1) [11]. Invasive front is divided into 3 distinct categories: group-A is defined by glandular shape without presence of single invasive cells, group-B is consisted of trabecular structures accompanied with early invasion of surrounding stroma and group-C is described by presence of solid structure or diffuse infiltration [4]

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