Tumor Budding In Adenocarcinoma Research Articles

Tumor budding in tumor tissue among operatively treated patients with lung adenocarcinoma

Background/Aim. The histological phenomenon of tumor budding is being recognized as an important determinant of disease progression and poor prognosis in various types of carcinoma. We aimed to evaluate the clinicopathological significance of tumor budding in adenocarcinoma of the lung. Methods. The study included 114 patients operatively treated for lung adenocarcinoma in a one-year period. Microscopic analysis of routine histological slides was performed to establish the presence and density of tumor buds. These results were compared in relation to gender, age, tumor size, nodal status, and pathological stage. Results. The budding-positive group included 34 (53.1%) men and 27 (54%) women. There were 30 (46.9%) men and 23 (46%) women in the budding-negative group. No statistical significant difference in age was found between males (64.3 ? 6.59 years) and females (63.1 ? 6.53 years) in the budding-positive group, nor in the budding-negative group (males 63.3 ? 6.02 years; females 63.2 ? 6.72 years). Statistically significant result in tumor size was found in females with the presence of tumor budding (p < 0.05). The budding-positive group of patients in nodal stage N1 and stage III of the disease pointed to the statistical significance (p < 0.05). Conclusion. With the statistical significance confirmed between the higher nodal status, higher pathological stage, and tumor budding found in this study, this histological phenomenon is still relatively new for the diagnostics domain of pathology. However, it increasingly receives attention as an adverse prognostic factor. These results may help tumor budding incorporate into the existing staging systems in addition to other factors known to be predictors of worse outcome.

Tumor Budding in Colorectal Carcinoma: Translating a Morphologic Score Into Clinically Meaningful Results.

- Tumor budding has received increasing recognition as an important independent prognostic factor in colorectal carcinoma. Prominent tumor budding in adenocarcinoma arising in a polyp has been shown to be a risk factor for lymph node involvement. The variability in methods used for evaluating tumor budding in different studies and lack of standardized guidelines have impeded routine inclusion of tumor budding in pathology reports. This changed last year with consensus guidelines based on the International Tumor Budding Consensus Conference (ITBCC). These guidelines have been included in the recent College of American Pathologists (CAPs) Colorectal Cancer Protocol. The consensus methodology will allow uniform reporting of this finding, but challenges in interpretation in the setting of intense inflammation, fibrosis, or gland fragmentation need to be addressed in future guidelines. - To provide a brief overview of the known clinical significance of tumor budding in colorectal carcinoma and discuss the practical aspects of its implementation on a routine basis. - English-language pathology literature. - Tumor budding has been shown to be an independent prognostic marker in colorectal carcinomas and the routine reporting of tumor buds is now advocated by using the approach outlined by the ITBCC guidelines. Tumor budding is included in the CAP protocol as a recommended element. Presence of prominent tumor budding in an adenocarcinoma in a polyp may have implications for management, such as additional resection, while it serves as a prognostic factor in other settings.

Histopathologic Features of the Tumor Budding in Adenocarcinoma of the Lung: Tumor Budding As an Index to Predict the Potential Aggressiveness

The term tumor budding has been applied to single cells or small clusters of up to four cells within the stromal tissue at the invasive margin of colorectal cancers. This morphologic feature is increasingly being recognized as an adverse prognostic factor. The purpose of this study was to evaluate the clinicopathologic significance of tumor budding in adenocarcinomas of the lung. We investigated the relationship between tumor budding and clinicopathologic parameters of adenocarcinomas of the lung and the prognostic significance of tumor budding by reviewing the cases of 201 consecutive patients who had undergone complete resection of adenocarcinoma of the lung measuring 30 mm or less in diameter. We examined immunohistochemical profile of budding cells (BCs) by immunohistochemical staining with 14 antibodies. Tumor budding was observed in 78 (43.1%) of the 181 cases with invasive adenocarcinoma. The presence of tumor budding was significantly associated with lymph node metastasis (p = 0.005), pathologic stage (p < 0.001), vascular invasion (p = 0.003), lymphatic invasion (p = 0.009), and pleural invasion (p = 0.029). Examination of the relation between the presence of tumor budding and the predominant histologic subtype revealed that the predominant papillary subtype was significantly associated with the presence of tumor budding (p = 0.0023), whereas the predominant bronchioloalveolar carcinoma subtype was significantly associated with the absence of tumor budding (p < 0.001). The overall 5-year survival rates of the group with budding and the group without budding was 67.5% and 88.3%, respectively, and difference was significant (p = 0.0057). Compared with cancer cells forming nests, BCs displayed reduced expression of cellular adhesion molecule, E-cadherin, and beta-catenin (p < 0.05 and p < 0.05, respectively) and increased expression of laminin5-gamma2 (p < 0.05). However, BCs displayed reduced expression of differentiation marker, surfactant protein A (p < 0.05). Multivariate analysis revealed that tumor budding was significant independent prognostic factor of the small-sized adenocarcinoma of the lung. Our data showed that tumor budding in adenocarcinoma of the lung is a distinct morphologic feature that has biologic and prognostic significance.