High-yield areas to grade tumor budding in colorectal cancer: A practical approach for pathologists |
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Affiliation: | 1. Department of Pathology, Rutgers University School of Medicine, Newark, NJ, United States of America;2. Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States of America;3. Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States of America;1. Department of Histopathology, Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore, Pakistan;2. Department of Urology, Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore, Pakistan;1. Department of Pathology, Yale School of Medicine, New Haven, CT, United States of America;2. Currently affiliated with Memorial Sloan Kettering Cancer Center, New York, United States of America;3. Applied Mathematics Program, Yale University, New Haven, CT, United States of America;4. Medical Scientist Training Program, Yale School of Medicine, New Haven, CT, United States of America;5. Department of Medicine (Endocrinology), Yale School of Medicine, New Haven, CT, United States of America;1. Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, United States of America;2. Department of Pathology, Rutgers University New Jersey Medical School, Newark, NJ, United States of America |
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Abstract: | BackgroundTumor budding (TB) has significant prognostic implication in stage II colorectal cancer (CRC) and is graded based on the International Tumor Budding Consensus Conference (ITBCC) protocol. In the current study, we evaluate tumor budding and its relationship to multiple histologic features in 104 tumors.MethodsOne-hundred four resected CRC cases were retrieved. Tumor bud count and TB grade were compared to the final tumor bud count/TB grade of the tumor per ITBCC protocol. The following high-yield co-features were assessed in each slide: highest T stage, presence of benign mucosa, presence of a precursor lesion, and highest tumor volume.ResultsTwenty-nine (28 %) cases had discrepancies between slide TB grade and final TB grade. The least discrepancies were seen in slides with benign mucosa (7 %) and precursor lesions (7 %). Among stage II patients without high-risk features, no discrepancies were observed in slides with benign mucosa. Slides with deepest invasion (rs = 1.000, p = 0.01) and benign mucosa (rs = 0.957, p < 0.001) had the strongest correlation with final tumor bud count in the same stage II subgroup. Similar relationships were observed when comparing final TB grade. Deepest invasion, tumor volume, as well as lymphovascular invasion, when present, also showed strong correlations with final TB grade in the entire cohort (rs = 0.828–0.845, p < 0.001).ConclusionOur study is the first study to evaluate the relationship between TB grade and co-existing histologic features. We highlight the benefit of focusing on slides with high-yield co-features, with the strongest correlation seen in slides with adjacent benign mucosa and precursor lesions. |
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