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Histopathological study of tumor budding in colorectal carcinoma and its correlation with clinicopathological parameters

Protik Mondal, Bhawna Bhutoria Jain, Sourav Kumar Ghosh, Ayandip Nandi.


Background: Colorectal cancer (CRC) is the third most common cancer worldwide. “Tumor budding,” defined by the presence of five or less tumor cell cluster in the invasive front of tumor, is a strong, reproducible, and independent prognostic marker of the biological aggressiveness of the tumor.

Aim and Objective: The present study was conducted to assess the correlation of clinicopathological parameter with tumor budding in CRC.

Materials and Methods: Sixty patients presenting with colectomy specimens with known histological diagnosis of colorectal adenocarcinoma were included in the study. Histological examination with hematoxylene and eosin stain and immunohistochemistry with pancytokeratin (Pan-CK) was performed in equivocal cases. Tumor budding was counted and scored as per international tumor budding consensus conference, 2016, recommended criteria. Tumor budding was correlated with other relevant clinicopathological parameters.

Results: The age distribution ranged from 19 to 78 years with a peak incidence in the age group of 41–50 years (31.7%). Low-grade tumor budding was seen in 20%, intermediate grade budding in 16.7%, and high-grade tumor budding in 63.3%. No correlation could be established between age, sex, site, size of tumor, lymphovascular invasion, histological grade, and budding intensity. However, association between tumor budding and nodal involvement, perineural invasion and higher American Joint Committee on Cancer stage has been found to be statistically significant in this study.

Conclusions: Tumor budding is emerging to be a promising and powerful predictor of nodal metastasis and a higher stage of the tumor. Immunohistochemistry with Pan-CK can aid in the grading of tumor budding and buid consensus.

Key words: Colorectal Carcinoma; Immunohistochemistry; International Tumor Budding Consensus Conference Criteria; Pancytokeratin; Tumor, Node, Metastasis Staging; Tumor Budding

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