Tumour budding in colorectal carcinoma: Association with other histopathological prognostic parameters

Abstract

Colorectal carcinoma (CRC) is the third leading cancer in India. Pathologists play a crucial role in assessing stage, analyzing surgical margins and documenting the histopathologic prognostic parameters. Tumour budding is one such prognostic parameter, defined as single cells or small groups of tumour cells (up to 4 cell clusters) at the invasive front of the tumour. The aim of this study is to examine the association of tumour budding with other histopathological prognostic parameters in patients with colorectal carcinoma.TheHematoxylin & Eosin (H &E) stained slides of 52 histopathologically diagnosed CRC resection specimens were reviewed and tumour budding (BD) was assessed into four grades under 200x power. Other histopathological prognostic parameters like tumour size, site, grade, laterality, lymphovascular invasion, perineural invasion, T and N stage were analyzed using descriptive statistics and Chi-square test with Software SPSS version 23.A higher BD score is seen to be more often associated with grade 3 tumour morphology, presence of perineural invasion, tumour size of 5cm or more and tumours located in the sigmoid colon or rectum. No association of tumour budding is seen with TIL’s or tumour of size < 5cm.Tumour budding is a practical and significant histological index for identification of high malignant potential and poor outcome in CRC patients with rectal or sigmoid colon location, size more than 5cm, perineural invasion and higher histological grade. Tumour budding may help identify patients who need a more intensive postoperative follow up and the possibility of adjuvant therapy.