Intratumoural budding (ITB) in preoperative biopsies predicts the presence of lymph node and distant metastases in colon and rectal cancer patients

In colorectal cancer (CRC), tumour budding at the invasion front is associated with lymph node (LN) and distant metastasis. Interestingly, tumour budding can also be detected in biopsies (intratumoural budding; ITB) and may have similar clinical importance. Here we investigate whether ITB in preoper...

Full description

Saved in:
Bibliographic Details
Published in:British journal of cancer 2014-02, Vol.110 (4), p.1008-1013
Main Authors: ZLOBEC, I, HÄDRICH, M, DAWSON, H, KOELZER, V. H, BORNER, M, MALLAEV, M, SCHNÜRIGER, B, INDERBITZIN, D, LUGLI, A
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anion Exchange Protein 1, Erythrocyte - metabolism
Antiporters - metabolism
Biological and medical sciences
Biomarkers, Tumor - metabolism
Biopsy
Cancer therapies
Colon - pathology
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Colorectal cancer
Female
Hematologic and hematopoietic diseases
Hospitals
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymph Nodes - pathology
Lymphatic Metastasis
Lymphatic system
Male
Medical research
Medical sciences
Metastasis
Middle Aged
Molecular Diagnostics
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Pathology
Patients
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectum - pathology
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In colorectal cancer (CRC), tumour budding at the invasion front is associated with lymph node (LN) and distant metastasis. Interestingly, tumour budding can also be detected in biopsies (intratumoural budding; ITB) and may have similar clinical importance. Here we investigate whether ITB in preoperative CRC biopsies can be translated into daily diagnostic practice. Preoperative biopsies from 133 CRC patients (no neoadjuvant therapy) underwent immunohistochemistry for pan-cytokeratin marker AE1/AE3. Across all biopsies for each patient, the densest region of buds at × 40 (high-power field; HPF) was identified and buds were counted. A greater number of tumour buds in the biopsy was associated with pT stage (P=0.0143), LN metastasis (P=0.0007), lymphatic (P=0.0065) and venous vessel invasion (P=0.0318) and distant metastasis (cM1) (P=0.0013). Using logistic regression, a 'scale' was developed to estimate the probability of LN and distant metastasis using the number of tumour buds (e.g. 10 buds per HPF: 64% chance of LN metastasis; 30 buds per HPF: 86% chance). Inter-observer agreement for ITB was excellent (intraclass correlation coefficient: 0.813). Tumour budding can be assessed in the preoperative biopsy of CRC patients. It is practical, reproducible and predictive of LN and distant metastasis. Intratumoural budding qualifies for further investigation in the prospective setting.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.2013.797