Association of Tumour Budding With Histological Type And Grade, Pathological Stage And Lymph Node Metastasis In Colorectal Carcinoma

Authors

  • Wajahat Ahmed Khan Armed Force Institute of Pathology/National Institute of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Bushra Parveen Armed Force Institute of Pathology/National Institute of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Asif Combined Military Hospital Lahore/ National Institute of Medical Sciences (NUMS) Pakistan
  • Muhammad Usman Rathore Armed Force Institute of Pathology/National Institute of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Farhat Rashid Armed Force Institute of Pathology/National Institute of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hassan Tariq Combined Military Hospital Malir/ National Institute of Medical Sciences (NUMS) Pakistan
  • Naveed Khan Armed Force Institute of Pathology/National Institute of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i1.10290

Keywords:

Colorectal carcinoma (CRC), Prognostic marker, Tumour budding

Abstract

Objective: To investigate the association between the tumour budding of colorectal carcinoma and its histological type, grade, lymph node metastasis, and pathological stage.

Study Design: Cross-sectional study

Place and Duration of Study: Histopathology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Dec 2021 to Mar 2023.

Methodology: One hundred and twenty colorectal carcinoma patients were examined for existence and severity using Hematoxylin and Eosin-stained sections. According to the number of tumour buds, cases were categorised as low grade (<10/200X), intermediate grade (10-19/200X), and high grade (>20/200X). These categories were related to lymph node involvement, histological type and grade, and pathological staging. In challenging cases, pan-cytokeratin immunohistochemistry labelling was conducted to confirm tumour budding.

Results: The mean age of presentation was 55.78±12.47 years. The most common site of involvement was the ascending colon 66(55%), followed by the recto-sigmoid colon 29(24.2%). Most cases were conventional adenocarcinoma 80(67%), followed by mucinous carcinoma 31(26%). Most cases were moderately differentiated 62(52%) and were stage III 79(66%). Forty-two (35%) had low-grade, and thirty-four (28.3%) had intermediate-grade and high-grade tumour budding. Tumour budding significantly correlates with tumour size, histological grade, invasion extent, and lympho-vascular invasion (p-value <0.05).

Conclusion: Tumour budding is strongly associated with nodal metastasis and a high grade of colorectal carcinoma; thus, it must be considered an important independent adverse prognostic indicator for colorectal carcinoma.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6): 394-424. https://doi.org/10.3322/caac.21492 Erratum in: CA Cancer J Clin 2020 ;70(4):313.

Idrees R, Fatima S, Abdul-Ghafar J, Raheem A, Ahmad Z. Cancer prevalence in Pakistan: meta-analysis of various published studies to determine variation in cancer figures resulting from marked population heterogeneity in different parts of the country. World J Surg Oncol 2018; 16: 129. https://doi.org/10.1186%2Fs12957-018-1429-z

Mitrovic B, Schaeffer DF, Riddell RH, Kirsch R. Tumor budding in colorectal carcinoma: time to take notice. Mod Pathol

; 25(10): 1315-1325. https://doi.org/10.1038/modpathol.2012.94

Küçük Ü, Ekmekçi S, Çakır E, Ekin Z, Ergani B, Ekin GR. Prognostic significance of tumor budding in muscle invasive urothelial carcinomas of the bladder. Turk J Urol 2018; 45(4): 273-278. https://doi.org/10.5152/tud.2018.58269

Koelzer VH, Zlobec I, Lugli A. Tumor budding in colorectal cancer--ready for diagnostic practice? Hum Pathol 2016; 47(1) :4-19. https://doi.org/10.1016/j.humpath.2015.08.007

Sert-Bektaş S, Inan Mamak G, Cırış IM, Bozkurt KK, Kapucuoğlu N. Tumor budding in colorectal carcinomas. Turk Patoloji Derg 2012;28(1):61-66. https://doi.org/10.5146/tjpath.2012.01099

Badar F, Mahmood S, Yusuf MA, Sultan F. Epidemiology of cancers in Lahore, Pakistan, 2010-2012: a cross-sectional study. BMJ Open 2016; 6(6): e011828. https://doi.org/10.1136/bmjopen-2016-011828

Shida D, Kanemitsu Y, Hamaguchi T, Shimada Y. Introducing the eighth edition of the tumor-node-metastasis classification as relevant to colorectal cancer, anal cancer and appendiceal cancer: a comparison study with the seventh edition of the tumor-node-metastasis and the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma. Jpn J Clin Oncol 2019; 49(4): 321-328. https://doi.org/10.1093/jjco/hyy198

Ueno H, Murphy J, Jass JR, Mochizuki H, Talbot IC. Tumour 'budding' as an index to estimate the potential of aggressiveness in rectal cancer. Histopathology 2002; 40(2): 127-32. https://doi.org/10.1046/j.1365-2559.2002.01324.x

Siegel RL, Jakubowski CD, Fedewa SA, Davis A, Azad NS. Colorectal Cancer in the Young: Epidemiology, Prevention, Management. Am Soc Clin Oncol Educ Book 2020; 40: 1-14. https://doi.org/10.1200/EDBK_279901

Hasan F, Shah SMM, Munaf M, Khan MR, Marsia S, Haaris SM, et al. Barriers to colorectal cancer screening in Pakistan. Cureus 2017; 9(7): e1477. https://doi.org/10.7759%2Fcureus.1477

Pancione M, Giordano G, Remo A, Febbraro A, Sabatino L, Manfrin E, et al. Immune escape mechanisms in colorectal cancer pathogenesis and liver metastasis. J Immunol Res. 2014; 2014: 686879. https://doi.org/10.1155%2F2014%2F686879

Mármol I, Sánchez-de-Diego C, Pradilla Dieste A, Cerrada E, Rodriguez Yoldi MJ. Colorectal carcinoma: a general overview and future perspectives in colorectal cancer. Int J Mol Sci 2017; 18(1): 197. https://doi.org/10.3390/ijms18010197

Remo A, Fassan M, Vanoli A, Bonetti LR, Barresi V, Tatangelo F, et al. Morphology and molecular features of rare colorectal carcinoma histotypes. Cancers 2019; 11(7): 1036. https://doi.org/10.3390/cancers11071036

El-Gendi S, Al-Gendi A. Assessment of tumor budding in colorectal carcinoma: correlation with β-catenin nuclear expression. J Egypt Natl Canc Inst 2011; 23(1): 1-9. https://doi.org/10.1016/j.jnci.2011.07.001

Fleming M, Ravula S, Tatishchev SF, Wang HL. Colorectal carcinoma: Pathologic aspects. J Gastrointest Oncol 2012; 3(3): 153-173. https://doi.org/10.3978/j.issn.2078-6891.2012.030

Pancione M, Remo A, Colantuoni V. Genetic and epigenetic events generate multiple pathways in colorectal cancer progression. Patholog Res Int 2012; 2012: 509348. https://doi.org/10.1155/2012/509348

Mehta A, Goswami M, Sinha R, Dogra A. Histopathological Significance and Prognostic Impact of Tumor Budding in Colorectal Cancer. Asian Pac J Cancer Prev 2018; 19(9): 2447-2453. https://doi.org/10.22034/APJCP.2018.19.9.2447

Morodomi T, Isomoto H, Shirouzu K, Kakegawa K, Irie K, Morimatsu M. An index for estimating the probability of lymph node metastasis in rectal cancers. Lymph node metastasis and the histopathology of actively invasive regions of cancer. Cancer 1989; 63(3): 539-43. https://doi.org/10.1002/1097-0142(19890201)63:3%3C539::aid-cncr2820630323%3E3.0.co;2-s

Goldstein NS, Hart J. Histologic features associated with lymph node metastasis in stage T1 and superficial T2 rectal adenocarcinomas in abdominoperineal resection specimens. Identifying a subset of patients for whom treatment with adjuvant therapy or completion abdominoperineal resection should be considered after local excision. Am J Clin Pathol 1999; 111(1): 51-58. https://doi.org/10.1093/ajcp/111.1.51

Ueno H, Price AB, Wilkinson KH, Jass JR, Mochizuki H, Talbot IC. A new prognostic staging system for rectal cancer. Ann Surg 2004; 240(5): 832-839.

https://doi.org/10.1097/01.sla.0000143243.81014.f2

Downloads

Published

28-02-2024

How to Cite

Khan, W. A., Parveen, B., Muhammad Asif, Muhammad Usman Rathore, Farhat Rashid, Hassan Tariq, & Naveed Khan. (2024). Association of Tumour Budding With Histological Type And Grade, Pathological Stage And Lymph Node Metastasis In Colorectal Carcinoma. Pakistan Armed Forces Medical Journal, 74(1), 206–210. https://doi.org/10.51253/pafmj.v74i1.10290

Issue

Section

Original Articles

Most read articles by the same author(s)