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Park JH, Shin JI, Lim BJ. Prognostic significance of tumour budding in noncolorectal gastrointestinal tract and pancreatobiliary tract: a systematic review and meta-analysis. Histopathology 2024; 84:1079-1091. [PMID: 38362762 DOI: 10.1111/his.15154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
Tumour budding shows promise as a prognostic factor in various cancers, but its widespread application is hindered by the lack of large, validated studies and standardized criteria. This meta-analysis aims to review and examine the prognostic role of tumour budding specifically in noncolorectal gastrointestinal and pancreatobiliary tract cancers, broadening our perspective on its clinical relevance. The literature review was conducted through PubMed, Embase, and Web of Science from inception till 20 February 2023. Pooled odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated to assess the relation between tumour budding and clinicopathologic features, as well as overall survival. Each study was evaluated using the Newcastle-Ottawa Scale and both heterogeneity and publication bias were analysed. In this meta-analysis of 57 studies across various cancer types, multivariate HR revealed worse overall survival in oesophageal squamous cell carcinoma (HR 3.34 [95% CI 2.21-5.04]), gastric adenocarcinoma (2.03 [1.38-2.99]), pancreatic ductal adenocarcinoma (2.56 [2.02-3.25]), and biliary tract adenocarcinoma (3.11 [2.46-3.93]) with high-grade tumour budding. Additionally, high-grade tumour budding consistently correlated with adverse clinicopathological features, including lymph node metastasis, lymphovascular invasion, and distant metastasis without any observed inverse association. High heterogeneity was noted. Our study suggests that tumour budding is a valuable prognostic marker in various cancers. Nonetheless, standardized criteria tailored to specific organ types are necessary to enhance its clinical utility.
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Affiliation(s)
- Ji Hyun Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Beom Jin Lim
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Hui Z, Wang B, Liu Z, Wei J, Gan J, Landstrom M, Mu Y, Zang G. TGFβ-induced EN1 promotes tumor budding of adenoid cystic carcinoma in patient-derived organoid model. Int J Cancer 2024; 154:1814-1827. [PMID: 38282121 DOI: 10.1002/ijc.34856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/23/2023] [Accepted: 12/20/2023] [Indexed: 01/30/2024]
Abstract
Adenoid cystic carcinoma (ACC) and basal cell adenoma (BCA) share many histological characteristics and often need a differential diagnosis in clinical pathology. Recently, we found homeobox protein engrailed-1 (EN1) was a potential diagnostic marker for ACC in an organoids library of salivary gland tumors (SGTs). Here we aim to confirm EN1 as a differential diagnostic marker for ACC, and further investigate the regulatory mechanism and biological function of EN1 in tumor progression. The transcriptional analysis, quantitative polymerase chain reaction, Western blot and immunohistochemistry staining were performed and revealed that EN1 was specifically and highly expressed in ACC, and accurately differentiated ACC from BCA. Furthermore, TGFβ signaling pathway was found associated with ACC, and the regulation of EN1 through TGFβ was detected in the human ACC cell lines and patient-derived organoids (PDOs). TGFβ-induced EN1 was important in promoting tumor budding in the PDOs model. Interestingly, a high level of EN1 and TGFβ1 in the budding tips was observed in ACC clinical samples, and the expression of EN1 and TGFβ1 in ACC was significantly associated with the clinical stage. In summary, our study verified EN1 is a good diagnostic marker to differentiate ACC from BCA. TGFβ-induced EN1 facilitates the tumor budding of ACC, which might be an important mechanism related to the malignant phenotype of ACC.
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Affiliation(s)
- Zhixuan Hui
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
| | - Bo Wang
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
| | - Zhengyan Liu
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
| | - Jinhui Wei
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
| | - Jiaxing Gan
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
| | - Marene Landstrom
- Department of Medical Bioscience, Building 6M, Umeå University, Umeå, Sweden
| | - Yabing Mu
- Department of Medical Bioscience, Building 6M, Umeå University, Umeå, Sweden
| | - Guangxiang Zang
- Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Shenyang City, China
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Vasudevan S, Kannan K, Raghavan AV, Sulochana S. Analyzing Tumor Budding Scores in Invasive Breast Carcinoma: A Tertiary Care Center Study in South India. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1850-S1853. [PMID: 38882784 PMCID: PMC11174339 DOI: 10.4103/jpbs.jpbs_910_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 06/18/2024] Open
Abstract
Introduction and Aim Tumor budding is a distinctive phenomenon which involves the presence of small clusters or individual cancer cells at the invasive front of tumors. Tumor budding has garnered attention due to its potential implications for prognosis, treatment strategies, and our understanding of cancer progression. Our aim is to study the distribution of tumor buds and its scoring in patients with infiltrating breast carcinoma and to associate with other histopathological parameters like the size of the tumor, its grade, lymphovascular invasion, and lymph node metastasis. Materials and Methods This was a study analyzing the data of 70 resected specimens of primary breast carcinomas and providing a descriptive overview. Tumor budding was recognized, counted, and graded in hematoxylin and eosin slides. The cases were classified as low (0-4), intermediate (5-9), and high (≥10 buds) based on the count of tumor buds. Tumor budding has significant correlation with tumor grade and tumor size. Results Of the 70 cases, 60 cases (85.71%) were diagnosed as invasive ductal carcinoma NOS. The majority [38 (54.28%)] of the cases showed an intermediate tumor budding score of 5-9/10 HPF. Conclusion Evaluation of tumor budding allows pathologists and oncologists to gather valuable information about the tumor's biological aggressiveness and potential for metastasis. It also helps in better risk stratification of patients, enabling a more personalized and tailored approach to treatment planning. In conclusion, assessing tumor budding in breast carcinoma holds significant clinical importance in the management and prognosis of this disease.
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Affiliation(s)
- Sudha Vasudevan
- Department of Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) University, Thandalam, Chennai, Tamil Nadu, India
| | - Kavitha Kannan
- Department of Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) University, Thandalam, Chennai, Tamil Nadu, India
| | - Atm Venkat Raghavan
- Department of Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) University, Thandalam, Chennai, Tamil Nadu, India
| | - Sonti Sulochana
- Department of Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) University, Thandalam, Chennai, Tamil Nadu, India
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Zanoletti E, Daloiso A, Nicolè L, Cazzador D, Mondello T, Franz L, Astolfi L, Marioni G. Tumor budding to investigate local invasion, metastasis, and prognosis of head and neck carcinoma: A systematic review. Head Neck 2024; 46:651-671. [PMID: 38013617 DOI: 10.1002/hed.27583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
The aim of this systematic review is to shed light on the role of tumor budding (TB) in the biology, behavior, and prognosis of head and neck squamous cell carcinoma (HNSCC). A search was run in PubMed, Scopus, and Embase databases following PRISMA guidelines. After full-text screening and application of inclusion/exclusion criteria, 36 articles were included. Several investigations support the prognostic role of TB, which might play a role in selecting rational treatment strategies. To achieve this goal, further research is needed for greater standardization in TB quantification. Although TB is not included as a negative prognostic factor in the current management guidelines, it might be reasonable to consider a closer follow-up for HNSCC cases with high histopathological evidence of TB.
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Affiliation(s)
- Elisabetta Zanoletti
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Antonio Daloiso
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Lorenzo Nicolè
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Pathology & Cytopathology Unit, Ospedale dell'Angelo, Venezia-Mestre, Italy
| | - Diego Cazzador
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Tiziana Mondello
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Leonardo Franz
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
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Deshpande NS, Munemane AB, Karle RR, Dongre SD. Relevance of Tumor Budding and Pattern of Invasion in Oral Squamous Cell Carcinoma. Int J Appl Basic Med Res 2024; 14:29-34. [PMID: 38504839 PMCID: PMC10947764 DOI: 10.4103/ijabmr.ijabmr_391_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 03/21/2024] Open
Abstract
Background Standard histopathological parameters such as depth of invasion (DOI), lymphovascular invasion (LVI), and perineural invasion (PNI) are known parameters that can correlate with the prognosis and aggressiveness of oral squamous cell carcinomas (OSCCs). Tumor budding (TB) (≤5 tumor cells at infiltrating borders) and pattern of invasion (POI) are emerging histopathological parameters that have shown promising results as reliable risk factors in predicting nodal metastasis in early OSCCs. Aim The aim of the study was to assess TB and POI in OSCCs. Materials and Methods A total of 33 surgical resection specimens of OSCC, including buccal mucosa and tongue with neck dissection, were selected. TB and POI along with standard parameters such as grade, DOI, LVI, PNI, lymph node status, and pathological staging were evaluated. These parameters were analyzed in comparison with lymph node involvement and pathological stage of the tumor using the Chi-square and Fischer's exact test. The SPSS software, v21, was used for statistical analyses. Results Most of OSCC were moderately differentiated tumors (63.64%). TB was present in 23 cases, in which 69.57% of cases showed low TB (<5 buds), while 30.43% of cases had higher TB (>5 buds). The worst POI (Patterns 4 and 5) was seen in 75.76% of cases. TB, POI, grade, PNI, DOI, and stromal pattern were significantly associated with the pathological stage of the tumor. Conclusion TB and POI are important and reliable in histopathological parameters in OSCCs.
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Affiliation(s)
- Nikhil Sanjay Deshpande
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Anil B. Munemane
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Ravindra Raosaheb Karle
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
| | - Suryakant Dattatreya Dongre
- Department of Pathology, Dr. BVP Rural Medical College, Pravara Institute of Medical Sciences (DU), Ahmednagar, Maharashtra, India
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Ranaee M, Torabi H, Azhganzad N, Shirini K, Hosseini AS, Hajian K. The Relationship Between Tumor Budding and Patient's Survival in Breast Cancer. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2024; 17:2632010X241235543. [PMID: 38487273 PMCID: PMC10938609 DOI: 10.1177/2632010x241235543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/10/2024] [Indexed: 03/17/2024]
Abstract
Introduction Breast cancer is a severe life-threatening condition in which many women are involved yearly. One factor that has recently been noticed and investigated as a diagnostic predictor of this type of cancer is the number of tumor buds and the relation of this factor with a patient's survival rate. Materials and methods This study includes 150 female patients over 18 years old with a mean age of 53.99 ± 12.56 years old with breast cancer, which was diagnosed at various medical centers, including Rouhani Hospital itself, and referred to Rouhani Hospital Medical Center, Babol, Iran. The number of intratumoral and peritumoral buds in patients' microscopic slides were archived and evaluated along with tumor microenvironment on hematoxylin and eosin (H&E) slides and compared to other clinicopathological findings. This article precisely investigated the relationship between the number of intratumoral and peritumoral buds with patients' 5-year survival rate. Also, the relationship between age, tumor stage, grade, size, the number of lymph nodes involved, and the presence of metastasis with the number of intratumoral and peritumoral buds was studied. Results and discussion The result showed a significant statistical association between the number of intratumoral and peritumoral buds with tumor size, tumor stage, presence of metastasis, the number of lymph nodes involved, and 5-year survival rate. On the other hand, there is not a significant statistical association between the number of intratumoral and peritumoral buds with age and tumor grade. Conclusion Our investigation revealed a significant statistical relationship between the number of tumor buds and patients' survival rate. So, this factor should be considered significant to help those patients increase their survival ratio.
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Affiliation(s)
- Mohammad Ranaee
- Department of Pathology, Rouhani Hospital, Babol University of Medical Science, Babol, Iran
| | - Hossein Torabi
- Department of General Surgery, Poursina Medical and Educational Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Narges Azhganzad
- Department of Pathology, Poursina Medical and Educational Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Kasra Shirini
- Department of General Surgery, Iran University of Medical Science, Tehran, Iran
| | - Akram Sadat Hosseini
- Department of Pathology, Rouhani Hospital, Babol University of Medical Science, Babol, Iran
| | - Karimollah Hajian
- Department of Statistics and Epidemiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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Niranjan KC, Raj M, Hallikeri K. Prognostic evaluation of tumour budding in oral squamous cell carcinoma: Evidenced by CD44 expression as a cancer stem cell marker. Pathol Res Pract 2023; 251:154883. [PMID: 37898041 DOI: 10.1016/j.prp.2023.154883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES Tumor budding is a sign of invasion and early step for metastasis of many cancers including oral squamous cell carcinoma (OSCC). Evidences suggest the presence of cancer stem cells in tumor buds. CD44 has been reported in tumor growth and metastasis as a cancer stem cell marker in OSCC. The study aims to highlight the prognostic significance of tumor budding in association with CD44 expression as a cancer stem cell marker in OSCC. METHODS A total of 60 radical neck dissection specimens of OSCC with and without lymph node metastasis were included in the study. The sections were evaluated for TB [Tumor Budding] in H&E and CD44 expression immunohistochemically. OSCC cases were then correlated with clinicopathologic and histomorphologic parameters such as age, gender, habit, site, staging, grading, recurrence, depth of invasion, pattern of invasion, and survival outcomes. Comparison of prognosis and CD44 expression were carried out by statistical methods. RESULTS A high TB score was significantly correlated with grading (p = 0.037), POI [Pattern of invasion] (0.029), overall survival (p = 0.047). CD44 over expression showed strong correlations with POI (1HPF:p = 0.037;10HPF:p = 0.027), grading (p = 0.037), and overall survival (p = 0.047). Kaplan-Meier analysis revealed overall survival advantage for LTB [Low TB] (85 %) with OSCC compare to HTB [High TB] (75 %) for > 36 months. CONCLUSION Assessment of TB is effective in predicting prognosis of OSCC. Although CD44 expression has demonstrated strong prognostic influence, there were significant differences in its expression with the parameters.
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Affiliation(s)
- Kochli Channappa Niranjan
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, SDM College of Dental Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad 580 009, Karnataka, India.
| | - Monica Raj
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, SDM College of Dental Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad 580 009, Karnataka, India
| | - Kaveri Hallikeri
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, SDM College of Dental Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad 580 009, Karnataka, India
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Buch A, Khan U, Rathod H, Jain K, Dwivedi A, Rajesh A. Tumor budding in breast carcinoma: A systematic review and meta-analysis. J Cancer Res Ther 2023; 19:1697-1713. [PMID: 38376268 DOI: 10.4103/jcrt.jcrt_188_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/04/2022] [Indexed: 02/21/2024]
Abstract
ABSTRACT Tumor budding is gaining importance as a prognostic factor in various carcinomas due to its association with epithelial-mesenchymal transition (EMT) and hence clinical outcome. Reporting tumor budding in breast cancer lacks homogeneity. We aim to systematically review the existing literature and conduct a meta-analysis to assess the prognostic implication of tumor budding in breast carcinoma. A systematic search was performed to identify studies that compared different prognostic variables between high- and low-grade tumor budding. Quality assessment was performed using a modified Newcastle Ottawa Scale. Dichotomous variables were pooled using the odds ratio using the Der-Simonian-Laird method. Meta-analysis was conducted to study the association between low/high-grade tumor budding and tumor grade, lymph node metastasis, lymphovascular invasion, ER, PR, HER2neu, KI67, and the molecular subtype triple-negative breast carcinoma. Thirteen studies with a total of 1763 patients were included. A moderate risk of bias was noted. The median bias scoring was 7 (6-9). High-grade tumor budding was significantly associated with lymph node metastasis (OR: 2.25, 95% CI: 1.52-3.34, P < 0.01) and lymphovascular invasion (OR: 3.14, 95% CI: 2.10-4.71, P < 0.01), and low-grade budding was significantly associated with triple-negative breast carcinoma (OR: 0.61, 95% CI: 0.39-0.95, P = 0.03)There was significant heterogeneity in the assessment and grading of tumor budding; thus, a checklist of items was identified that lacked standardization. Our meta-analysis concluded that tumor budding can act as an independent prognostic marker for breast cancer.
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Affiliation(s)
- Archana Buch
- Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Uzair Khan
- Department of Undergraduate Students Section, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Hetal Rathod
- Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Khushi Jain
- Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Aryan Dwivedi
- Department of Undergraduate Students Section, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Arasi Rajesh
- Department of Pathology, Tirunelveli Medical College, Tamil Nadu, India
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Ozer SP. Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230191. [PMID: 37792866 PMCID: PMC10547490 DOI: 10.1590/1806-9282.20230191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Tumor budding is currently thought to be associated with worse prognosis. This study aims to examine tumor budding in invasive ductal-type breast carcinoma and its relationship with other clinicopathological parameters and overall survival. METHODS All the H&E slides of 198 patients were re-evaluated for the histological grade, angiolymphatic invasion, perineural invasion, lymph node status, extranodal extension, multicentricity, pT, presence of the tumor budding, tumor budding score (i.e., low, intermediate, or high). Overall survival was considered the period after surgery until death. SPSS was used for statistical analysis. RESULTS Tumor budding was identified in 98 (49.5%) patients. Tumor budding score was low in 41 (41.8%) of 98 cases, intermediate in 25 (25.5%), and high in 32 (32.7%). We determined a strong correlation between tumor budding and poor prognostic variables such as tumor size, pT stage, angiolymphatic invasion, perineural invasion, number of metastatic axillary lymph nodes, overall survival, and extranodal tumor extension in metastatic lymph nodes. This strong correlation was also present for the tumor budding score. CONCLUSION Tumor budding may be a prognostic indicator for breast cancer.
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Affiliation(s)
- Songul Peltek Ozer
- Bolu Abant Izzet Baysal Training and Research Hospital, Department of Pathology – Bolu, Turkey
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Savli TB, Pasaoglu HE, Savli TC, Muhammedoglu A, Tokocin M, Öztürk Ç. Expression of cytotoxic T lymphocyte-associated antigen 4, CD44, and E-cadherin in the microenvironment of breast carcinomas. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230371. [PMID: 37466609 PMCID: PMC10351999 DOI: 10.1590/1806-9282.20230371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/28/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE The expression of cytotoxic T lymphocyte-associated antigen 4, E-cadherin, and CD44 in the area of tumor budding was investigated in breast carcinomas in our study. METHODS Tumor budding was counted at the invasive margins in 179 breast carcinomas. To understand the microenvironment of tumor budding, we examined the expression status of the immune checkpoint molecules such as cytotoxic T lymphocyte-associated antigen 4, E-cadherin, and CD44. RESULTS Tumors were separated into low (≤5) and high tumor budding groups (>5) based on the median budding number. Lymphovascular, perineural invasion, and the number of metastatic lymph nodes were significantly higher in high-grade budding tumors (p=0.001, p<0.001, and p=0.019, respectively). Tumor-infiltrating lymphocytes were significantly higher in tumors without tumor buddings (p<0.001). When the number of budding increases by one unit, overall survival decreases by 1.07 times (p=0.013). Also, it increases the risk of progression by 1.06 times (p=0.048). In high tumor budding groups, the cytotoxic T lymphocyte-associated antigen 4 staining percentage of lymphocytes was significantly higher (p=0.026). With each increase in the number of buds, an increase in the percentage of cytotoxic T lymphocyte-associated antigen 4 staining was seen in lymphocytes in the microenvironment of TB (p=0.034). CONCLUSION Tumor budding could predict poor prognosis in breast carcinomas, and anti-cytotoxic T lymphocyte-associated antigen 4 immunotherapies may be beneficial in patients with high tumor budding tumors.
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Affiliation(s)
- Tugce Bolme Savli
- Gaziantep Cengiz Gokcek Maternity and Child Health Hospital, Department of Pathology - Gaziantep, Turkey
| | - Husniye Esra Pasaoglu
- Istanbul Bagcilar Training and Research Hospital, Department of Pathology - Istanbul, Turkey
| | - Taha Cumhan Savli
- Medipol Mega University Hospital, Department of Pathology - Istanbul, Turkey
| | - Ali Muhammedoglu
- Istanbul Bagcilar Training and Research Hospital, Department of Pathology - Istanbul, Turkey
| | - Merve Tokocin
- Istanbul Bagcilar Training and Research Hospital, Department of General Surgery - Istanbul, Turkey
| | - Çiğdem Öztürk
- Recep Tayyip Erdoğan University Training and Research Hospital, Pathology Department - Rize, Turkey
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Su CY, Wu A, Dong Z, Miller CP, Suarez A, Ewald AJ, Ahn EH, Kim DH. Tumor stromal topography promotes chemoresistance in migrating breast cancer cell clusters. Biomaterials 2023; 298:122128. [PMID: 37121102 PMCID: PMC10291492 DOI: 10.1016/j.biomaterials.2023.122128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 05/02/2023]
Abstract
Multicellular clustering provides cancer cells with survival advantages and facilitates metastasis. At the tumor migration front, cancer cell clusters are surrounded by an aligned stromal topography. It remains unknown whether aligned stromal topography regulates the resistance of migrating cancer cell clusters to therapeutics. Using a hybrid nanopatterned model to characterize breast cancer cell clusters at the migration front with aligned stromal topography, we demonstrate that topography-induced migrating cancer cell clusters exhibit upregulated cytochrome P450 family 1 (CYP1) drug metabolism and downregulated glycolysis gene signatures, which correlates with unfavorable prognosis. Screening on approved oncology drugs shows that cancer cell clusters on aligned stromal topography are more resistant to diverse chemotherapeutics. Full-dose drug testings further indicate that topography induces drug resistance of hormone receptor-positive breast cancer cell clusters to doxorubicin and tamoxifen and triple-negative breast cancer cell clusters to doxorubicin by activating the aryl hydrocarbon receptor (AhR)/CYP1 pathways. Inhibiting the AhR/CYP1 pathway restores reactive oxygen species-mediated drug sensitivity to migrating cancer cell clusters, suggesting a plausible therapeutic direction for preventing metastatic recurrence.
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Affiliation(s)
- Chia-Yi Su
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Alex Wu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Zhipeng Dong
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Chris P Miller
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Allister Suarez
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Andrew J Ewald
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Cell Biology and Center for Cell Dynamics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Eun Hyun Ahn
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States.
| | - Deok-Ho Kim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States; Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, United States; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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Öztürk Ç, Okcu O, Öztürk SD, Aşkan G, Şen B, Bedir R. A new practical method of estimating tumoral microenvironment parameters of possible prognostic significance in patients with invasive breast carcinoma: Combined microenvironment score. Ann Diagn Pathol 2023; 64:152128. [PMID: 36905704 DOI: 10.1016/j.anndiagpath.2023.152128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND OBJECTIVE In recent years, the tumor microenvironment has become increasingly recognized as an influential factor in breast cancer development and growth. The parameters that form the microenvironment are the tumor stroma ratio and tumor infiltrating lymphocytes. In addition, tumor budding, which shows the ability of the tumor to metastasize, gives information about the progression of the tumor. In this study, the combined microenvironment score (CMS) was determined with these parameters, and the relationship between CMS and prognostic parameters and survival was evaluated. MATERIALS AND METHODS In our study, tumor stroma ratio, tumor infiltrating lymphocytes, and tumor budding were evaluated in hematoxylin-eosin sections of 419 patients with invasive ductal carcinoma. Patients were scored separately for each of these parameters, and these scores were summed to determine the CMS. The patients were divided into 3 groups according to CMS and the relationship between CMS and prognostic parameters and the survival of the patients was studied. RESULTS The patients with CMS 3 had higher histological grade and Ki67 proliferation index compared to CMS 1 and 2. Additionally, lymphovascular invasion, axillary lymph node and distant metastasis were more common. Disease-free, and overall survival were significantly shortened in the CMS 3 group. CMS was found as an independent risk factor for DFS (HR: 2.144 (95 % CI: 1.219-3.77) p: 0.008), but not an independent risk factor for OS. CONCLUSION CMS is a prognostic parameter that can be easily evaluated and does not require extra time and cost. Evaluating the morphological parameters of the microenvironment with a single scoring system will contribute to routine pathology practice and predict patient prognosis.
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Affiliation(s)
- Çiğdem Öztürk
- Recep Tayyip Erdoğan University Training and Research Hospital, Pathology Department, Türkiye.
| | - Oğuzhan Okcu
- Recep Tayyip Erdoğan University, Faculty of Medicine, Pathology Department, Türkiye
| | - Seda Duman Öztürk
- Recep Tayyip Erdoğan University Training and Research Hospital, Pathology Department, Türkiye; Kocaeli University Faculty of Medicine, Pathology Department, Türkiye
| | - Gökçe Aşkan
- Recep Tayyip Erdoğan University Training and Research Hospital, Pathology Department, Türkiye; İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Pathology Department, Türkiye
| | - Bayram Şen
- Recep Tayyip Erdoğan University Training and Research Hospital, Biochemistry Department, Türkiye
| | - Recep Bedir
- Recep Tayyip Erdoğan University, Faculty of Medicine, Pathology Department, Türkiye
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13
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Kundu T, Giri R, Hota SK, Sahu SK, Senapati U. Tumour budding in invasive breast carcinoma and its correlation with histopathological prognostic parameters and hormone receptor status. J Cancer Res Ther 2023; 19:S664-S668. [PMID: 38384036 DOI: 10.4103/jcrt.jcrt_656_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/25/2022] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Tumor Budding (TB) is emerging as an important sensitive indicator of aggressiveness over traditional histopathological variables such as lymph node metastasis and lymphovascular invasion because TB at the invasive front was postulated as the first step of invasion and metastasis. But the role of TB in breast carcinoma is not yet standardized. AIM This study aims to assess the prognostic significance of TB in breast carcinoma. OBJECTIVES To study and grade TB in invasive breast carcinoma and correlate it with known histopathological prognostic markers and hormone receptor status. MATERIALS AND METHODS In this ambispective study, 51 cases of invasive breast carcinoma undergoing radical surgery were studied from September 2017 to September 2021. Tumor buds were defined as a single or cluster of up to four tumor cells at the invasive front of the tumor and were counted by using IHC Pancytokeratin in 200X and graded into a three-tier grading system. The correlation between TB with established histopathological parameters and hormone receptor status was studied. A Chi-square test was used and a P value < 0.05 was considered significant. RESULTS TB was seen in all cases of invasive breast carcinoma. Grade 1 TB was seen in 37.26% (19/51) of cases and Grade 2 TB and Grade 3 TB in 31.37% (16/51) of cases each. There was a lack of significant correlation between TB with histologic grade, lymph node status, and HER2 neu. Correlation between TB with Estrogen receptor (ER), Progesterone receptor (PR), and American Joint Committee on Cancer (AJCC) Prognostic stage group was noted but it was not statistically significant. CONCLUSION Although several studies have confirmed the prognostic value of TB in breast carcinoma, they had used several different methods of assessment. So, there is a need for a standardized method for the assessment of TB in breast carcinoma. Further standardization of TB may add its value as a prognostic factor.
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Affiliation(s)
- Tamanna Kundu
- Department of Pathology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Ranjana Giri
- Department of Pathology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Subhransu K Hota
- Department of Pathology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Subrat K Sahu
- Department of Oncosurgery, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Urmila Senapati
- Department of Pathology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
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14
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Does the number of cell forming tumor budding alter the prognostic value in invasive ductal carcinoma of breast? Pathol Res Pract 2022; 240:154157. [DOI: 10.1016/j.prp.2022.154157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/03/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
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15
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Huang T, Bao H, Meng YH, Zhu JL, Chu XD, Chu XL, Pan JH. Tumour budding is a novel marker in breast cancer: the clinical application and future prospects. Ann Med 2022; 54:1303-1312. [PMID: 35535687 PMCID: PMC9103277 DOI: 10.1080/07853890.2022.2070272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Breast cancer (BC) is a group of markedly heterogeneous tumours. There are many subtypes with different biological behaviours and clinicopathological characteristics, leading to significantly different prognosis. Despite significant advances in the treatment of BC, early metastatic is a critical factor for poor prognosis in BC patients. Tumour budding (TB) is considered as the first step process of tumour metastasis and is related to the epithelial-mesenchymal transition (EMT). TB has been observed in a variety of cancers, such as colorectal and gastric cancer, and had been considered as a distinct clinicopathological characteristics for early metastasis. However, TB evaluation standards and clinical application are not uniform in BC, as well as its molecular mechanism is not fully understood. Here, we reviewed the interpretation criteria, mechanism, clinicopathological characteristics and clinical application prospects of TB in BC. Key messagesCurrently, tumour budding is a poor prognosis for various solid tumours, also in breast cancer.Tumour budding is based on epithelial-mesenchymal transition and tumour microenvironment factors and is presumed to be an early step in the metastatic process.Breast cancer tumour budding still needs multi-centre experiments. We summarize the current research on breast cancer tumour budding, analyse the method of discriminating breast cancer tumour budding and explore the prognostic role and mechanism in breast cancer.
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Affiliation(s)
- Ting Huang
- Department of Clinical Pathology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hui Bao
- Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yu-Hua Meng
- Department of Clinical Pathology, the First People's Hospital of Shunde, Foshan, China
| | - Jian-Lin Zhu
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiao-Dong Chu
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiao-Li Chu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong, China.,Guangdong Provincial Key laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases, Guangzhou, China
| | - Jing-Hua Pan
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
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16
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Rathod GB, Desai KN, Shrivastava A, Maru AM. Correlation of Tumor Budding With Known Clinicopathological, Histomorphological and Hormonal Receptor Status in Patients With Invasive Breast Carcinoma. Cureus 2022; 14:e29637. [DOI: 10.7759/cureus.29637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
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17
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Thakur N, Ailia MJ, Chong Y, Shin OR, Yim K. Tumor Budding as a Marker for Poor Prognosis and Epithelial-Mesenchymal Transition in Lung Cancer: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:828999. [PMID: 35719992 PMCID: PMC9201279 DOI: 10.3389/fonc.2022.828999] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 05/05/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Currently, tumor budding (TB) is considered to predict the prognosis of patients. The prognostic significance of TB has also been explored in patients with lung cancer, but has not been fully clarified. In the present meta-analysis, we evaluated the prognostic significance, clinicopathological value, and relationship with epithelial–mesenchymal transition (EMT) of TB in lung cancer. Methods The MEDLINE, EMBASE, and Cochrane databases were searched up to July 7, 2021, for the relevant articles that showed the relationship between TB and prognosis in patients with lung cancer. For statistical analysis, we used pooled hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) to assess the correlation between high-grade TB expression and overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), clinicopathological factors, and EMT markers. Results A total of 3,784 patients from 10 independent studies were included in the statistical analysis. Our results indicated that high-grade TB was significantly associated with poor OS [HR 1.64 (95% CI, 1.43–1.87)] and DFS [HR 1.65 (95% CI, 1.22–2.25)]. In terms of clinicopathological characteristics, high-grade TB was associated with larger tumor size, higher T and N stage, pleural invasion, vascular invasion, lymphatic invasion, and severe nuclear atypia. Interestingly, smoking showed significant association with high-grade TB, despite the fact that previous studies could not show a significant relationship between them. Furthermore, through our systematic analysis, high-grade TB showed a significant relationship with EMT markers. Conclusion Our findings indicate that high-grade TB is associated with a worse prognosis in patients with lung cancer. TB evaluation should be implemented in routine pathological diagnosis, which may guide the patient’s treatment.
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Affiliation(s)
- Nishant Thakur
- Department of Hospital Pathology, The Catholic University of Korea, Seoul, South Korea
| | - Muhammad Joan Ailia
- Department of Hospital Pathology, The Catholic University of Korea, Seoul, South Korea
| | - Yosep Chong
- Department of Hospital Pathology, The Catholic University of Korea, Seoul, South Korea
| | - Ok Ran Shin
- Department of Hospital Pathology, The Catholic University of Korea, Seoul, South Korea
| | - Kwangil Yim
- Department of Hospital Pathology, The Catholic University of Korea, Seoul, South Korea
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18
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Singh T, Chandra K, Kumar N, Mishra A, Singh S, Singh A, Kumar U, Kumar P. A Retrospective Study of Association of Tumor Budding, Tumor Microenvironment, and Clinicopathological Characteristics of Invasive Breast Carcinoma. J Lab Physicians 2022; 14:485-490. [DOI: 10.1055/s-0042-1747676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Background Tumor budding (TB) has been identified in many solid cancers and thought to be involved in invasion and is the initial step in the metastatic process. Limited information is available documenting the role of tumor budding in breast carcinoma. With this aim, the present study evaluates the association of tumor budding, tumor microenvironment, and its correlation with clinicopathologic parameters.
Materials and Methods A total of 102 cases were archived and evaluated for peripheral and intra tumoral budding along with tumor microenvironment on hematoxylin and eosin (H&E) slides.
Statistical Analysis Correlation between tumor budding, tumor microenvironment, and other classical clinicopathological parameters was studied by Chi-square test. A p-value less than 0.05 was considered significant.
Results Females constituted 99 cases out of 102 and 3 were males. We found 55.9% and 44.1% of patients in the age group less than or equal to 50 and greater than 50, respectively. Also, 65.6% of cases presented with small tumor size less than or equal to 5 cm, 80.39% with lymph node metastasis, and 76.4% with lympho-vascular emboli. High peripheral tumoral budding (PTB) was seen in 45.10%, low peripheral tumoral budding in 54.9%, high ITB in 53.9%, and low ITB in 46.1%. Necrosis was found only in 39.21%. Significant statistical association of PTB was found with lymph node metastasis, lymphovascular emboli, and tumor necrosis, whereas ITB with tumor grade, lymph node metastasis, lympho-vascular emboli, and necrosis. Both PTB and ITB showed no statistically significant correlation with age and size of the tumor.
Conclusion Tumor budding is an independent adverse prognostic factor in invasive breast carcinoma. However, further work is needed to establish a standard method for the quantification of this parameter, which will help in effective stratification of patients in terms of disease-free survival and likely outcome.
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Affiliation(s)
- Tanwi Singh
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Kalpana Chandra
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Nidhish Kumar
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Anuja Mishra
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Sanjeet Singh
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Anju Singh
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Umesh Kumar
- Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Praveen Kumar
- General Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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19
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Ailia MJ, Thakur N, Chong Y, Yim K. Tumor Budding in Gynecologic Cancer as a Marker for Poor Survival: A Systematic Review and Meta-Analysis of the Perspectives of Epithelial-Mesenchymal Transition. Cancers (Basel) 2022; 14:1431. [PMID: 35326582 PMCID: PMC8946491 DOI: 10.3390/cancers14061431] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 01/25/2023] Open
Abstract
This study aimed to assess the prognostic significance, assessment methods, and molecular features of tumor budding (TB). A literature search of Medline, EMBASE, Cochrane Library, and eleven cohort studies (seven cervical and four endometrial cancers) was conducted. Three assessment methods for TB involving 2009 patients were collected and constituted in the analysis. Our meta-analysis showed that TB was a marker of poor survival, regardless of the cancer origin site or assessment method (overall survival: hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.82-3.17; disease-free survival: HR, 3.32; 95% CI, 2.46-4.48). In endometrial cancers, TB is associated with the epithelial-mesenchymal transition, microvessel density, and decreased hormone receptor expression. Thus, we suggest TB as a poor prognostic marker for all gynecologic cancers.
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Affiliation(s)
| | | | | | - Kwangil Yim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (M.J.A.); (N.T.); (Y.C.)
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20
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Xiang Z, He Q, Huang L, Xiong B, Xiang Q. Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation. Front Oncol 2022; 11:818869. [PMID: 35083162 PMCID: PMC8784696 DOI: 10.3389/fonc.2021.818869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Tumor budding (TB) is emerging as a prognostic factor in multiple cancers. Likewise, the stemness of cancer cells also plays a vital role in cancer progression. However, nearly no research has focused on the interaction of TB and tumor stemness in cancer. Methods Tissue microarrays including 229 cases of invasive breast cancer (BC) were established and subjected to pan-cytokeratin immunohistochemical staining to evaluate molecular expression. Univariate and multivariate analyses were applied to identify prognostic factors of BC, and the Chi-square test was used for comparison of categorical variables. Results High-grade TB was significantly associated with T stage, lymph node metastasis, tumor node metastasis (TNM) stage, epithelial-mesenchymal transition, and poor disease-free survival (DFS) of BC patients. We also found that the prognostic value of TB varied widely among different subtypes and subgroups. Cox regression analysis then showed that TB grade was an independent prognostic factor. Moreover, cancer stem cell (CSC) markers CD44 and ALDH1A1 were significantly higher in high-grade TB tumors. Consequently, patients were classified into high CSC score subgroup and low CSC score subgroups. Further research found that CSC scores correlated with clinicopathological features and DFS of BC patients. Based on TB grade and CSC scores, we classified BC patients into TBlow-CSCslow (type I), TBlow-CSCshigh (type II), TBhigh-CSCslow (type III), and TBhigh-CSCshigh (type IV) subgroups. Survival analysis showed that patients in the type I subgroup had the best DFS, whereas those in the type IV subgroup had the worst DFS. Finally, a TB-CSC-based nomogram for use in BC was established. The nomogram was well calibrated to predict the probability of 5-year DFS, and the C-index was 0.837. Finally, the area under the curve value for the nomogram (0.892) was higher than that of the TNM staging system (0.713). Conclusion The combination of TB grade with CSC score improves the prognostic evaluation of BC patients. A novel nomogram containing TB grade and CSC score provides doctors with a candidate tool to guide the individualized treatment of cancer patients.
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Affiliation(s)
- Zhenxian Xiang
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Qiuming He
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Li Huang
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Xiong
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Qingming Xiang
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China.,Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, China
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21
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Goyal S, Banga P, Meena N, Chauhan G, Sakhuja P, Agarwal AK. Prognostic significance of tumour budding, tumour-stroma ratio and desmoplastic stromal reaction in gall bladder carcinoma. J Clin Pathol 2021; 76:308-314. [PMID: 34853164 DOI: 10.1136/jclinpath-2021-207957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/03/2021] [Indexed: 11/04/2022]
Abstract
AIMS AND METHODS The prognostic role of tumour budding (TBd) and its interaction with the stromal microenvironment has gained a lot of attention recently, but remains unexplored in gall bladder cancer (GBC). We aimed to study the interrelationship of TBd by International Tumour Budding Consensus Conference scoring system, tumour-stroma ratio (TSR) and desmoplastic stromal reaction (DSR) with the conventional clinicopathological prognostic factors, mortality and overall survival (OS) in 96 patients of operated GBC. RESULTS Higher age, high TNM stage, lymphovascular and perineural invasion, positive resection margins, higher TBd score, low TSR and immature DSR were significantly associated with worse OS. However, on multivariate analysis, only metastases, positive resection margins and TSR <50% proved to be independent prognostic factors. The TBd score of stroma-rich tumour group (6.40±4.69) was significantly higher than that of stroma-poor group (2.77±3.79, p≤0.001). The TBd score of immature and intermediate DSR groups was significantly higher than that of mature group (p≤0.001 and p=0.002, respectively). There was a strong interobserver agreement for TBd score, TSR and type of DSR (Cohen's Kappa=0.726 to 0.864, p≤0.001). Stroma-rich tumours were significantly associated with immature DSR and fibrotic DSR with high TSR (p≤0.001). CONCLUSION A high TBd, low TSR and immature DSR were significantly associated with several high-risk clinicopathological parameters and poor OS in GBC. These novel, simple, reproducible and cost-effective parameters may be included in the routine reporting checklist for GBC as additional prognostic parameters that can substratify the high-risk patients.
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Affiliation(s)
- Surbhi Goyal
- Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Priyanka Banga
- Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Nisha Meena
- Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Geeta Chauhan
- Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Puja Sakhuja
- Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
| | - Anil Kumar Agarwal
- Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, Delhi, India
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22
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Okcu O, Öztürk Ç, Şen B, Arpa M, Bedir R. Tumor Budding is a reliable predictor for death and metastasis in invasive ductal breast cancer and correlates with other prognostic clinicopathological parameters. Ann Diagn Pathol 2021; 54:151792. [PMID: 34293708 DOI: 10.1016/j.anndiagpath.2021.151792] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/18/2021] [Accepted: 07/11/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Breast cancers are the most common type of cancer and the most common cause of mortality in women worldwide. Different prognostic factors are the subject of research to differentiate the prognosis even between cases at a similar stage and identify risky patients earlier and create individual treatment approaches. Tumor budding (TB) has been identified as a poor prognostic factor in many types of cancer, especially colorectal carcinomas. In our study, we aimed to determine the prognostic significance of the TB by evaluating the TB in line with clinicopathological parameters in breast invasive ductal carcinoma cases. MATERIALS AND METHODS 311 breast carcinoma cases operated in our hospital between January 2010 and April 2020 were included in the study. In hematoxylin-eosin (H&E) sections of the cases, TB was evaluated in a single high-power field (HPF). ROC analysis was performed with overall survival data, and low, and high TB cutoffs were obtained. The relationship of the high TB with clinicopathological parameters was evaluated, and survival analysis was performed. RESULTS We determined that high TB in breast invasive ductal carcinoma cases was associated with low survival time, metastasis, axillary lymph node metastasis, angiolymphatic invasion, advanced stage (pT3), high Ki-67 proliferation index, progesterone receptor (PR) loss, and advanced age. Tumor budding was identified as an independent risk factor in overall and disease-free survival analysis. CONCLUSION Tumor budding is a prognostic parameter that can be easily evaluated in all centers since it does not cause additional cost to routine pathological examinations. We think it may be helpful to establish a standard methodology in evaluating tumor bud in breast carcinomas and including it in regular pathology reporting.
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Affiliation(s)
- Oğuzhan Okcu
- Recep Tayyip Erdoğan University Training and Research Hospital, Department of Pathology, Turkey.
| | - Çiğdem Öztürk
- Recep Tayyip Erdoğan University Training and Research Hospital, Department of Pathology, Turkey
| | - Bayram Şen
- Recep Tayyip Erdoğan University Training and Research Hospital, Department of Biochemistry, Turkey
| | - Medeni Arpa
- Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Medical Biochemistry, Turkey
| | - Recep Bedir
- Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Pathology, Turkey
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23
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Su CY, Burchett A, Dunworth M, Choi JS, Ewald AJ, Ahn EH, Kim DH. Engineering a 3D collective cancer invasion model with control over collagen fiber alignment. Biomaterials 2021; 275:120922. [PMID: 34126408 DOI: 10.1016/j.biomaterials.2021.120922] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 12/21/2022]
Abstract
Prior to cancer cell invasion, the structure of the extracellular matrix (ECM) surrounding the tumor is remodeled, such that circumferentially oriented matrix fibers become radially aligned. This predisposed radially aligned matrix structure serves as a critical regulator of cancer invasion. However, a biomimetic 3D model recapitulating a tumor's behavioral response to these ECM structures is not yet available. In this study, we have developed a phase-specific, force-guided method to establish a 3D dual topographical tumor model in which each tumor spheroid/organoid is surrounded by radially aligned collagen I fibers on one side and circumferentially oriented fibers on the opposite side. A coaxial rotating cylinder system was employed to construct the dual fiber topography and to pre-seed tumor spheroids/organoids within a single device. This system enables the application of different force mechanisms in the nucleation and elongation phases of collagen fiber polymerization to guide fiber alignment. In the nucleation phase, fiber alignment is enhanced by a horizontal laminar Couette flow driven by the inner cylinder rotation. In the elongation phase, fiber growth is guided by a vertical gravitational force to form a large aligned collagen matrix gel (35 × 25 × 0.5 mm) embedded with >1000 tumor spheroids. The fibers above each tumor spheroid are radially aligned along the direction of gravitational force in contrast to the circumferentially oriented fibers beneath each tumor spheroid/organoid, where the presence of the tumor interferes with the gravity-induced fiber alignment. After tumor invasion, there are more disseminated multicellular clusters on the radially aligned side, compared to the side of the tumor spheroid/organoid facing circumferentially oriented fibers. These results indicate that our 3D dual topographical model recapitulates the preference of tumors to invade and disseminate along radially aligned fibers. We anticipate that this 3D dual topographical model will have broad utility to those studying collective tumor invasion and that it has the potential to identify cancer invasion-targeted therapeutic agents.
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Affiliation(s)
- Chia-Yi Su
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alice Burchett
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Matthew Dunworth
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jong Seob Choi
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andrew J Ewald
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Cell Biology and Center for Cell Dynamics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Eun Hyun Ahn
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Deok-Ho Kim
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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Feng Y, Wang L, Wang T, Li Y, Xun Q, Zhang R, Liu L, Li L, Wang W, Tian Y, Yang L, Zhi X, Zhou B, Chen X, Sun T, Liu Y. RETRACTED: Tumor cell-secreted exosomal miR-22-3p inhibits transgelin and induces vascular abnormalization to promote tumor budding. Mol Ther 2021; 29:2151-2166. [PMID: 33578038 PMCID: PMC8178443 DOI: 10.1016/j.ymthe.2021.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/12/2020] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the editor-in-chief. The editor-in-chief was informed of evidence for image duplication in identical or altered fashion in Figures 3A and 8D, as well as undisclosed reuse of an image in Figure 5B from a previous article in Cell Death & Disease (https://doi.org/10.1038/s41419-018-0902-5), in a PubPeer thread: https://pubpeer.com/publications/F5B591481C516F4CE42C7925AC48E9. Image analysis performed by the journal's editorial office confirmed these findings. This reuse (and in part misrepresentation) of data without appropriate attribution represents a severe abuse of the scientific publishing system.
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Affiliation(s)
- Yaju Feng
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China; State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China
| | - Lumeng Wang
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China
| | - Ting Wang
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Ying Li
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Qingqing Xun
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China; School of Clinical Medicine, Jining Medical University, Jining 272029, Shangdong, China
| | - Renya Zhang
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Lin Liu
- Health Management Center, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Lei Li
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Wei Wang
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Yixuan Tian
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China
| | - Lili Yang
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Xiao Zhi
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China
| | - Bijiao Zhou
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China
| | - Xin Chen
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China
| | - Tao Sun
- State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Early Druggability Evaluation of Innovative Drugs and Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin 300457, China.
| | - Yanrong Liu
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272029, Shandong, China.
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25
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Georges NDF, Oberli B, Rau TT, Galván JA, Nagtegaal ID, Dawson H, Blank A, Kohler A, Lugli A, Zlobec I. Tumour budding and CD8 + T cells: 'attackers' and 'defenders' in rectal cancer with and without neoadjuvant chemoradiotherapy. Histopathology 2021; 78:1009-1018. [PMID: 33340423 DOI: 10.1111/his.14319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/17/2020] [Indexed: 01/17/2023]
Abstract
AIM Tumour budding ('attacker') and CD8+ T cells ('defender') are recognised as important parameters for risk stratification in colon cancers and, combined, may have an even stronger clinical impact. Here, we determine the value of tumour budding and CD8+ in rectal cancer patients treated with/without neoadjuvant therapy. METHODS AND RESULTS Using digital scans of all tumour slides/case, we analysed CD8+ T cell counts in two patient cohorts: 45 neoadjuvantly treated and 47 primarily surgically treated (totalling n = 543 slides) after double-staining of the surgical resection specimen for pan-cytokeratin and CD8+ . Tumour buds in hot-spots were manually counted (area = 0.785 mm2 ) and CD8+ T cell counts were analysed separately both in tumour budding hot-spots and the densest CD8+ regions throughout the tumour. In neoadjuvantly treated patients, only tumour budding and not CD8+ T cells was associated with tumour features, including more advanced ypT (P = 0.0062), venous invasion (P = 0.002), lymphatic invasion (P = 0.0003) and perineural invasion (P = 0.0017), as well as higher American Joint Committee on Cancer (AJCC) tumour regression score (P = 0.0035), indicating less tumour response. Overall survival was also worse in patients with high-grade budding in univariate analysis only. In contrast, all three variables, namely tumour budding (P = 0.0347), CD8+ T cells in budding hot-spots (P = 0.0382) and CD8+ T cells in the densest areas (P = 0.0117) were also associated with worse (budding) and better (CD8) survival time in the multivariate setting. CONCLUSION In rectal cancer, tumour budding has clinical relevance in both primarily surgically treated patients and in those with neoadjuvantly treated patients, where it characterises highly aggressive residual disease. CD8+ T cell counts appear not to have prognostic relevance in the neoadjuvant context.
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Affiliation(s)
| | - Beatrice Oberli
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tilman T Rau
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - José A Galván
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Iris D Nagtegaal
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Heather Dawson
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Annika Blank
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Andreas Kohler
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Inti Zlobec
- Institute of Pathology, University of Bern, Bern, Switzerland
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Gavriel CG, Dimitriou N, Brieu N, Nearchou IP, Arandjelović O, Schmidt G, Harrison DJ, Caie PD. Assessment of Immunological Features in Muscle-Invasive Bladder Cancer Prognosis Using Ensemble Learning. Cancers (Basel) 2021; 13:cancers13071624. [PMID: 33915698 PMCID: PMC8036815 DOI: 10.3390/cancers13071624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/03/2023] Open
Abstract
The clinical staging and prognosis of muscle-invasive bladder cancer (MIBC) routinely includes the assessment of patient tissue samples by a pathologist. Recent studies corroborate the importance of image analysis in identifying and quantifying immunological markers from tissue samples that can provide further insight into patient prognosis. In this paper, we apply multiplex immunofluorescence to MIBC tissue sections to capture whole-slide images and quantify potential prognostic markers related to lymphocytes, macrophages, tumour buds, and PD-L1. We propose a machine-learning-based approach for the prediction of 5 year prognosis with different combinations of image, clinical, and spatial features. An ensemble model comprising several functionally different models successfully stratifies MIBC patients into two risk groups with high statistical significance (p value < 1×10-5). Critical to improving MIBC survival rates, our method correctly classifies 71.4% of the patients who succumb to MIBC, which is significantly more than the 28.6% of the current clinical gold standard, the TNM staging system.
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Affiliation(s)
- Christos G. Gavriel
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
- Correspondence:
| | - Neofytos Dimitriou
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK; (N.D.); (O.A.)
| | - Nicolas Brieu
- Definiens GmbH, 80636 Munich, Germany; (N.B.); (G.S.)
| | - Ines P. Nearchou
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
| | - Ognjen Arandjelović
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK; (N.D.); (O.A.)
| | | | - David J. Harrison
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
- NHS Lothian, University Hospitals Division, Edinburgh EH16 4SA, UK
| | - Peter D. Caie
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (I.P.N.); (D.J.H.); (P.D.C.)
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Mozarowski P, Rasaiah B, Reed M, Lewis A, Walde N, Voutsadakis IA. Prognostic Role of Tumor Budding in Breast Cancer Patients Receiving Neo-Adjuvant Therapy. J Clin Med 2021; 10:jcm10040827. [PMID: 33670512 PMCID: PMC7922902 DOI: 10.3390/jcm10040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Isolated tumor cells or small clusters of tumor cells observed in the vicinity of the main tumor mass in pathology sections, termed tumor budding, are common in cancers and have been associated with prognosis in some settings. This study examined the clinical associations and treatment efficacy implications of tumor budding in breast cancer patients receiving neo-adjuvant therapy. Methods: Breast cancer patients that received neo-adjuvant therapy before definitive surgical treatment in a single cancer center over a 7-year period were included, and their records were reviewed. Data extracted included patient demographics, tumor characteristics and pathologic response to treatment at surgery. The initial breast cancer biopsy before any therapy was reviewed by two pathologists, and a hot spot area was evaluated for tumor budding (defined as 1 to 5 cancer cells observed detached from the main tumor mass). Results: Seventy-five patients who received neo-adjuvant therapy (73 received chemotherapy and 2 received hormonal therapy) were included. Tumor budding was observed in two-thirds of the patients. There were no significant differences in patient (age and menopause status) and tumor (stage, histology and molecular sub-type equivalent) characteristics between the group that had tumor budding and the group that did not have tumor budding in the pre-treatment biopsy. Likewise, no statistically significant differences were observed in the frequency of complete or partial responses between the two groups. Conclusion: In this cohort of breast cancer patients receiving neo-adjuvant therapy, tumor budding was frequent, but it was not associated with tumor characteristics or pathologic responses to treatment. The value of tumor budding as a prognostic factor in the neo-adjuvant setting within the general breast cancer population could not be confirmed, but such a value in specific sub-groups deserves further investigation, given the pathophysiologic rationale and data from other settings.
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Affiliation(s)
- Paul Mozarowski
- Department of Pathology, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (P.M.); (B.R.)
| | - Bhubendra Rasaiah
- Department of Pathology, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (P.M.); (B.R.)
| | - Melissa Reed
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
- Faculty of Medicine, University of Ottawa School of Medicine, Ottawa, ON KK1H 8M5, Canada
| | - Alexis Lewis
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
- Department of Biology, Algoma University, Sault Ste. Marie, ON P6A 2G4, Canada
| | - Natalie Walde
- Clinical Trials Unit, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada; (M.R.); (A.L.); (N.W.)
| | - Ioannis A. Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada
- Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
- Correspondence:
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González LO, Eiro N, Fraile M, Sánchez R, Andicoechea A, Fernández-Francos S, Schneider J, Vizoso FJ. Joint Tumor Bud-MMP/TIMP Count at the Invasive Front Improves the Prognostic Evaluation of Invasive Breast Carcinoma. Biomedicines 2021; 9:biomedicines9020196. [PMID: 33669393 PMCID: PMC7920253 DOI: 10.3390/biomedicines9020196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Tumor budding is a histological phenomenon consisting of the formation of small clusters of one to five undifferentiated malignant cells detached from the main tumor mass which are observed in the tumor stroma. In the present study, we investigated the prognostic significance of tumor budding in breast cancer and its relationship with the expressions of matrix metalloproteases (MMPs) and their tissue inhibitors (TIMPs). METHODS The number of buds was counted in whole-tissue sections from 153 patients with invasive ductal carcinomas who underwent a long follow-up period. In addition, an immunohistochemical study of MMP-9, -11, and -14 TIMP-1 and -2 expression by cell types at the invasive tumor front was carried out. RESULTS There was a wide variability in the number of buds among tumors, ranging from 0 to 28 (median = 5). Tumor budding count ≥ 4 was the optimal cut-off to predict both relapse-free and overall survival. High-grade tumor budding was associated with MMP/TIMP expression by cancer-associated fibroblasts. In addition, we found that the combination of tumor budding grade with MMP/TIMP expression by stromal cells, and especially with MMP-11 expression by mononuclear inflammatory cells, significantly improved the prognostic evaluation. CONCLUSION High-grade tumor budding is associated with a more aggressive tumor phenotype, which, combined with MMP/TIMP expression by stromal cells at the invasive front of the tumor, identifies patients with poor prognosis.
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Affiliation(s)
- Luis O. González
- Department of Anatomical Pathology, Fundación Hospital de Jove, 33290 Gijón, Spain;
| | - Noemi Eiro
- Research Unit, Fundación Hospital de Jove, 33290 Gijón, Spain; (N.E.); (M.F.); (S.F.-F.)
| | - María Fraile
- Research Unit, Fundación Hospital de Jove, 33290 Gijón, Spain; (N.E.); (M.F.); (S.F.-F.)
| | - Rosario Sánchez
- Department of Surgery, Fundación Hospital de Jove, 33290 Gijón, Spain; (R.S.); (A.A.)
| | - Alejandro Andicoechea
- Department of Surgery, Fundación Hospital de Jove, 33290 Gijón, Spain; (R.S.); (A.A.)
| | | | - Jose Schneider
- Department of Obstetrics and Gynecology, University of Valladolid, 47005 Valladolid, Spain;
| | - Francisco J. Vizoso
- Research Unit, Fundación Hospital de Jove, 33290 Gijón, Spain; (N.E.); (M.F.); (S.F.-F.)
- Department of Surgery, Fundación Hospital de Jove, 33290 Gijón, Spain; (R.S.); (A.A.)
- Correspondence: ; Tel.: +34-9-8532-0050 (ext. 84216); Fax: +34- 9-8531-5710
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Joshi P, Pol J, Chougule M, Jadhav K, Patil S, Patil S. Tumor budding - A promising prognostic histopathological parameter in oral squamous cell carcinoma - A comparative immunohistochemical study. J Oral Maxillofac Pathol 2021; 24:587. [PMID: 33967517 PMCID: PMC8083399 DOI: 10.4103/jomfp.jomfp_74_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction: The majority of the head and neck squamous cell carcinomas (HNSCC) occur in the oral cavity. Even with advances in cancer therapy only minor improvements in the survival of HNSCC patients have taken place and approximately 350,000 patients die annually of HNSCC worldwide. Tumor budding (TB) is a novel and promising histo-morphological parameter that has been studied in many cancers. The presence of TB is associated with lymph node and distant metastasis as well as poor survival, independently of the applied scoring system. The depth of tumor invasion (D) measured from the surface of the tumor to the deepest point of invasion is also an important prognostic parameter for oral squamous cell carcinoma (OSCC) with a cutoff point of 4 mm. Both taken together constitute BD model and it has also been found to be an independent prognostic factor for patients with OSCC. Therefore, it would be highly beneficial to evaluate TB and BD model in routine histopathological reporting. Aims and Objectives: This study aims to compare the detection of TB in hematoxylin-eosin and pan-cytokeratin stained immune-histochemical sections of OSCC and also to evaluate whether BD score can serve as a reliable prognostic indicator for OSCC. Methodology: A total of 30 formalin-fixed, paraffin-embedded tissue blocks of clinically and histopathologically diagnosed cases of OSCC were retrieved. One section was stained with hematoxylin and eosin and the other was processed for pancytokeratin immunohistochemistry to evaluate tumor buds. Depth of invasion (D) was also evaluated to achieve the BD score. Results: Statistical significance (P < 0.001) was noted between TB score evaluated in hematoxylin and eosin (H&E) and pancytokeratin stained sections. There was no statistical significance between age, gender, site of lesion, clinical staging, survival and BD score. Conclusion: Immunohistochemical analysis of TB is superior to H&E staining in detection of tumor buds at the tumor invasive front.
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Affiliation(s)
- Priya Joshi
- Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India
| | - Jaydeep Pol
- Department of Oncopathology, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India
| | - Madhuri Chougule
- Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India
| | - Kiran Jadhav
- Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India
| | - Sangeeta Patil
- Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India
| | - Swapnita Patil
- Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India
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30
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Kumarguru BN, Ramaswamy AS, Shaik S, Karri A, Srinivas VS, Prashant BM. Tumor budding in invasive breast cancer - An indispensable budding touchstone. INDIAN J PATHOL MICR 2020; 63:S117-S122. [PMID: 32108643 DOI: 10.4103/ijpm.ijpm_731_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Tumor budding denotes a phenomenon in which the tumor cells, singly or in small aggregates, become detached from the neoplastic glands at the invasive front of adenocarcinoma. Tumors with budding cells have a significantly more aggressive clinical course. Significance of tumor budding has mainly been examined in the field of colorectal cancer. Aims To document the number tumor buds at the invasive front of invasive breast cancer. To correlate the number of tumor buds with other histopathological parameters, and available clinical details. Setting and Study Design Analytical study at a rural tertiary care referral institute. Materials and Methods It was a retrospective study of invasive breast cancer cases from January 2012 to April 2015. Tumor buds were counted in H and E stained sections in 10 High Power Fields (HPFs). Association of tumor budding with histological parameters and available clinical details were analyzed statistically. Statistical Analysis Used Frequencies, Chi-Square Test and Crosstabs were used for calculation. Results 50 cases of invasive breast carcinoma were analyzed. Invasive ductal carcinoma constituted predominant histological type (92%). Low tumor budding (tumor buds ≤20/10HPFs) constituted 20 cases. High tumor budding (tumor buds >20/10HPFs) constituted 30 cases. Association of high tumor budding with lympho-vascular invasion, lymph node metastasis, primary tumor staging, regional lymph node staging, necrosis and Monckeberg medial sclerosis was statistically significant. Conclusion Tumor budding may be incorporated as a new parameter in reporting protocols. Tumor budding serves as an indispensable touchstone in evaluating cases of invasive breast cancer.
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Affiliation(s)
- B N Kumarguru
- Department of Pathology, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India
| | - Anikode S Ramaswamy
- Department of Pathology, PES Institute of Medical Sciences and Research, Kuppam, Chittoor, Andhra Pradesh, India
| | - Shahanuma Shaik
- Consultant Pathologist, Ashwini Diagnostics, Pogathota, Nellore, Andhra Pradesh, India
| | - Aruna Karri
- Consultant Pathologist, Lotus Hospitals, Srirampuram, Vishakapatnam, Andhra Pradesh, India
| | | | - B M Prashant
- Department of Pathology, Karwar Institute of Medical Sciences, Karwar, Karnataka, India
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Abstract
Tumour budding is an emerging prognostic biomarker in colorectal cancer (CRC) and other solid cancers. Tumour buds are usually defined as isolated single cancer cells or clusters of up to four cancer cells located at the invasive tumour front. The prognostic value of tumour budding is now supported by a large body of evidence, whereas the utility of this phenotype as a predictive biomarker remains under investigation. The application of tumour budding indices in clinical practice requires a standardized scoring system that can be tailored to specific tumour types and clinical scenarios. In the context of CRC, tumour budding can be assessed according to the method agreed at the International Tumour Budding Consensus Conference (ITBCC) in 2016. Using the ITBCC scoring system, tumour budding is an independent predictor of lymph node metastasis in patients with pT1 CRC and of unfavourable survival in patients with stage II colon cancer. Regardless of the clinical scenario or tumour type, the assertion that 'the more tumour buds, the worse the clinical outcome' applies. In this Review, we provide an overview of tumour budding in solid cancers, highlighting the molecular and biological aspects of this phenomenon, including its associations with epithelial-mesenchymal transition and features of the tumour microenvironment. We also describe the available evidence demonstrating the value of tumour budding as a biomarker across various solid cancers.
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32
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Guil-Luna S, Mena R, Navarrete-Sirvent C, López-Sánchez LM, Khouadri K, Toledano-Fonseca M, Mantrana A, Guler I, Villar C, Díaz C, Medina-Fernández FJ, De la Haba-Rodríguez JR, Aranda E, Rodríguez-Ariza A. Association of Tumor Budding With Immune Evasion Pathways in Primary Colorectal Cancer and Patient-Derived Xenografts. Front Med (Lausanne) 2020; 7:264. [PMID: 32719800 PMCID: PMC7347987 DOI: 10.3389/fmed.2020.00264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Tumor budding has been found to be of prognostic significance for several cancers, including colorectal cancer (CRC). Additionally, the molecular classification of CRC has led to the identification of different immune microenvironments linked to distinct prognosis and therapeutic response. However, the association between tumor budding and the different molecular subtypes of CRC and distinct immune profiles have not been fully elucidated. This study focused, firstly, on the validation of derived xenograft models (PDXs) for the evaluation of tumor budding and their human counterparts and, secondly, on the association between tumor budding and the immune tumor microenvironment by the analysis of gene expression signatures of immune checkpoints, Toll-like receptors (TLRs), and chemokine families. Clinical CRC samples with different grades of tumor budding and their corresponding PDXs were included in this study. Tumor budding grade was reliably reproduced in early passages of PDXs, and high-grade tumor budding was intimately related with a poor-prognosis CMS4 mesenchymal subtype. In addition, an upregulation of negative regulatory immune checkpoints (PDL1, TIM-3, NOX2, and IDO1), TLRs (TLR1, TLR3, TLR4, and TLR6), and chemokine receptors and ligands (CXCR2, CXCR4, CXCL1, CXCL2, CXCL6, and CXCL9) was detected in high-grade tumor budding in both human samples and their corresponding xenografts. Our data support a close link between high-grade tumor budding in CRC and a distinctive immune-suppressive microenvironment promoting tumor invasion, which may have a determinant role in the poor prognosis of the CMS4 mesenchymal subtype. In addition, our study demonstrates that PDX models may constitute a robust preclinical platform for the development of novel therapies directed against tumor budding in CRC.
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Affiliation(s)
- Silvia Guil-Luna
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Rafael Mena
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | | | - Laura María López-Sánchez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Karima Khouadri
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Marta Toledano-Fonseca
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Ana Mantrana
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Ipek Guler
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Carlos Villar
- Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Cesar Díaz
- Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - Juan Rafael De la Haba-Rodríguez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Unidad de Gestión Clínica de Oncología Médica, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Enrique Aranda
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Unidad de Gestión Clínica de Oncología Médica, Hospital Universitario Reina Sofía, Córdoba, Spain.,Departamento de Medicina, Facultad de Medicina de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Antonio Rodríguez-Ariza
- Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Unidad de Gestión Clínica de Oncología Médica, Hospital Universitario Reina Sofía, Córdoba, Spain
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Leite CF, Silva KDD, Horta MCR, de Aguiar MCF. Can morphological features evaluated in oral cancer biopsies influence in decision-making? A preliminary study. Pathol Res Pract 2020; 216:153138. [PMID: 32853958 DOI: 10.1016/j.prp.2020.153138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
Abstract
Tumor budding (TB) is a promising prognostic marker in many cancers including oral squamous cell carcinoma. The evaluation of TB in preoperative diagnostic biopsies has been proven be possible; therefore, the association of TB with other morphological features can represent an important aid in the previous treatment decision. This study aims to evaluate TB in oral squamous cell carcinoma (OSCC) biopsies, assessing its association with other morphological characteristics of the sample. A total of 56 cases of OSCC were investigated. In hematoxylin and eosin-stained slides, morphological features including histopathological grading and mode of invasion were evaluated in the deep invasive front. Moreover, immunohistochemistry was performed with anti-multi-cytokeratin antibody helping in the identification of TB, which was graded as low-intensity or no TB and high-intensity TB. Descriptive and bivariate analyses were performed, and the level of significance was set at 5%. The tongue was the most-affected site with 29 (51.7 %) tumors. The predominant mode of invasion (27-48.2 %) was by groups of neoplastic cells without clear boundaries. Of the cases investigated, 37 (66.1 %) were high-intensity TB, which was associated with the mode of invasion of the tumors (p < 0.05). All cases with the worst mode of invasion showed high-intensity TB. Preliminary results showed the potential of morphological features, such as TB and mode of invasion, evaluated in diagnostic specimens of OSCC, aiding in the treatment decision to select patients who could benefit from more-aggressive treatments.
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Affiliation(s)
- Camila Ferreira Leite
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal De Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Karine Duarte da Silva
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal De Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Martinho Campolina Rebello Horta
- Oral Pathology Section, School of Dentistry, Pontifical Catholic University of Minas Gerais (PUC Minas), Belo Horizonte, MG, Brazil.
| | - Maria Cássia Ferreira de Aguiar
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal De Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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The histopathological and molecular features of breast carcinoma with tumour budding-a systematic review and meta-analysis. Breast Cancer Res Treat 2020; 183:503-514. [PMID: 32710280 DOI: 10.1007/s10549-020-05810-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/15/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Tumour budding (TB) is an adverse histological feature in many epithelial cancers. It is thought to represent epithelial-mesenchymal transition, a key step in the metastatic process. The significance of TB in breast carcinoma (BC) remains unclear. The aim of this study is to investigate the relationship between TB and other histological and molecular features of BC. METHODS A systematic search was performed to identify studies that compared features of BC based on the presence or absence of high-grade TB. Dichotomous variables were pooled as odds ratios (OR) using the Der Simonian-Laird method. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale (NOS). RESULTS Seven studies with a total of 1040 patients (high-grade TB n = 519, 49.9%; low-grade/absent TB n = 521, 50.1%) were included. A moderate to high risk of bias was noted. The median NOS was 7 (range 6-8). High-grade TB was significantly associated with lymph node metastasis (OR 2.32, 95% c.i. 1.77 to 3.03, P < 0.001) and lymphovascular invasion (OR 3.08, 95% c.i. 2.13 to 4.47, P < 0.001). With regard to molecular subtypes, there was an increased likelihood of high-grade TB in oestrogen (OR 1.66, 95% c.i. 1.21 to 2.29, P = 0.002) and progesterone receptor-positive (OR 1.48, 95% c.i. 1.09 to 2.02, P = 0.01) tumours. In contrast, triple-negative breast cancer had a reduced incidence of high-grade TB (OR 0.46, 95% c.i. 0.30 to 0.72, P = 0.0006). CONCLUSION High-grade TB is enriched in hormone receptor-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic process of BC.
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Kluz T, Łoziński T, Czekierdowska S, Stachowicz N, Gurynowicz G, Chróściel M, Czekierdowski A. Tumor budding index and microvessel density assessment in patients with endometrial cancer: A pilot study. Oncol Lett 2020; 20:2701-2710. [PMID: 32782586 PMCID: PMC7399929 DOI: 10.3892/ol.2020.11811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The present study aimed to analyze the association between tumor budding index (TBI) and microvessel density (MVD) and selected clinicopathological features in female patients with endometrial cancer (EC). The present study included 137 patients, of whom 117 had endometrial endometrioid cancer and 3 had non-endometrioid EC (NEEC). Additionally, 8 cases of simple endometrial hyperplasia and 9 cases of atypical endometrial hyperplasia were included in the present study. Patient age, menopausal status, tumor histological type, grade and International Federation of Gynecologists and Obstetricians (FIGO) clinical stage were investigated. Immunohistochemistry was utilized to detect MVD using a CD34 antibody, and a laminin-5γ2 antibody was used for TBI assessment. In nonmalignant endometrial lesions, the TBI was significantly lower than that in patients with EC and NEEC (P=0.002). Significant differences in median TBI (MD-TBI) were also observed between patients with low-grade EC (MD-TBI, 4.5) and high-grade EC (MD-TBI, 16.2; P=0.01). Age, body mass index and tumor FIGO stage were not indicated to be associated with the MD-TBI. Premenopausal patients with EC had lower MD-TBI values than postmenopausal patients (0.3 vs. 11.1; P<0.005). The median MVD-CD34 in the study group was 19 (range, 13–29). Significant differences in MVD-CD34 were observed between malignant and nonmalignant endometrial lesions (P=0.01). Histological grade was markedly associated with tumor MVD-CD34 (P=0.001). The MVD was higher in high-grade cancer (G3; MVD-CD34, 24.9) than in grade G1 and G2 lesions (MVD-CD34, 14 and 18.6, respectively; P=0.01). FIGO clinical stage was not associated with MVD-CD34 in low and high stage lesions (MD, 18.4 for FIGO stage I/II; MD, 17.6 for FIGO stage III/IV; P=0.2). High MVD was markedly associated with high MD-TBI (P=0.0002). In conclusion, TBI could be a valuable indicator of tumor aggressiveness in patients with EC. The presence of the tumor budding phenomenon with increased MVD may have the potential to further refine clinical management decisions when endometrial malignancy is detected.
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Affiliation(s)
- Tomasz Kluz
- Department of Obstetrics and Gynecology, Fryderyk Chopin University Hospital No. 1, Faculty of Medicine, Rzeszow University, 35-055 Rzeszow, Poland
| | - Tomasz Łoziński
- Department of Obstetrics and Gynecology, Pro-Familia Hospital, 35-302 Rzeszow, Poland
| | - Sylwia Czekierdowska
- Department of Gynecological Oncology and Gynecology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Norbert Stachowicz
- Department of Gynecological Oncology and Gynecology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Grzegorz Gurynowicz
- Division of Perinatology and Women's Diseases, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Mieczysław Chróściel
- Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-081 Lublin, Poland
| | - Artur Czekierdowski
- Department of Gynecological Oncology and Gynecology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
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Zhang N, Wang D, Duan Y, Ayarick VA, Cao M, Wang Y, Zhang G, Wang Y. The special immune microenvironment of tumor budding and its impact on prognosis in gastric adenocarcinoma. Pathol Res Pract 2020; 216:152926. [PMID: 32327282 DOI: 10.1016/j.prp.2020.152926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/23/2020] [Accepted: 03/14/2020] [Indexed: 12/30/2022]
Abstract
Recent studies showed that the tumor-infiltrating lymphocytes (TILs) are not randomly distributed, but organized to accumulate more or less densely in different regions within tumors, which have provoked new thoughts on cancer management. In this study we explored the characteristics of tumor immunemicroenvironment (TIME) for the tumor budding (TB) and lymphocytes in patients with gastric adenocarcinoma (GAC) as well as their prognostic significance. The TILs around the TB at the invasive margin were assessed by double-immunohistochemistry staining for the CD8, FOXP3, OX40 and GrB phenotypes. Results showed that there was a negative correlation between the density of TB and TILs in the budding area, tumor stroma and parenchyma. And the number of TILs around the TB was evidently reduced, compared with TILs in the non-budding region (P < 0.001). Additionally, the number of TILs in turn changed from non-budding area CD8+>FOXP3+>OX40+> GrB + T cells to FOXP3+>CD8+>OX40 + T > GrB + T cells in budding area. Survival rate was significantly lower in patients who had a higher density of TB (P < 0.001) and a lower density of TILs (P = 0.013). We concluded that TB was surrounded by a weak immune surveillance and immunosuppressive response supported the spatial heterogeneity in the TIME of gastric adenocarcinomas. The regional heterogeneity should be attached importance for identifying the influence of the TIME on cancer development and evolution.
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Affiliation(s)
- Nana Zhang
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Depu Wang
- Department of Science and Technology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Yixin Duan
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Vivian Adiila Ayarick
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Meng Cao
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Ying Wang
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Guanjun Zhang
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, Shaanxi, 710061, China.
| | - Yili Wang
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
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37
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Ulase D, Heckl S, Behrens HM, Krüger S, Röcken C. Prognostic significance of tumour budding assessed in gastric carcinoma according to the criteria of the International Tumour Budding Consensus Conference. Histopathology 2019; 76:433-446. [PMID: 31538348 DOI: 10.1111/his.13997] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/16/2019] [Indexed: 12/24/2022]
Abstract
AIMS In this study, we aimed to independently evaluate the utility and prognostic value of tumour budding (TB) according to the International Tumour Budding Consensus Conference (ITBCC) criteria in a large and a well-characterised European gastric cancer (GC) cohort. METHODS AND RESULTS In 456 consecutive, surgically treated GCs, TB was assessed according to the ITBCC criteria and scored as Bd0 (no buds), Bd1 (one to four buds), Bd2 (five to nine buds) or Bd3 (≥10 buds). Cases with TB present were divided into low- (Bd1/Bd2) and high-budding (Bd3) groups. The TB score was analysed in relation to the clinicopathological parameters, overall survival (OS) and tumour-specific survival (TSS); 115 (25.2%) cases had no, 104 (22.8%) had low and 237 (52.0%) had high TB. The TB score correlated significantly with sex, Laurén phenotype, pT-, pN- and M categories, histological grade, R status; and lymph node ratio, lymphatic invasion, perineural invasion and HER2-, MET- and MSI status. In both total and intestinal-type early invasive GC (n = 57 and n = 41, respectively), significant associations between the presence and extent of TB and presence of lymph node metastasis were detected. Significant differences in OS and TSS between the TB groups were found; however, TB did not retain significance in multivariate models. CONCLUSIONS Our data show that the ITBCC criteria can be applied to GC. The data correlated significantly with the diverse clinicopathological characteristics, including patient outcome, and can help to standardise diagnostics and research into special histological features of malignant tumours in general and GC in particular.
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Affiliation(s)
- Dita Ulase
- Department of Pathology, Riga Stradins University, Riga, Latvia.,Department of Pathology, Christian-Albrechts-University, Kiel, Germany
| | - Steffen Heckl
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Pathology, Christian-Albrechts-University, Kiel, Germany
| | | | - Sandra Krüger
- Department of Pathology, Christian-Albrechts-University, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts-University, Kiel, Germany
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38
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Andisha NM, McMillan DC, Gujam FJA, Roseweir A, Edwards J. The relationship between phosphorylation status of focal adhesion kinases, molecular subtypes, tumour microenvironment and survival in patients with primary operable ductal breast cancer. Cell Signal 2019; 60:91-99. [PMID: 30981841 DOI: 10.1016/j.cellsig.2019.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/01/2019] [Accepted: 04/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite advances in therapies to treat breast cancer, over 100,000 patients die in the UK of this disease per year, highlighting the need to develop effect predictive and prognostic markers for patients with primary operable ductal breast cancer. Therefore, the aim of the present study was to examine the relationship between membranous, cytoplasmic and nuclear expression of focal adhesion kinase (phosphorylated at Y 397, Y 861 and Y 925), molecular subtypes, tumour microenvironment and survival in patients with primary operable ductal breast cancer. METHODS Four hundred and seventy-four patients presenting between 1995 and 1998 with primary operable ductal breast cancer were included in this study. Using tissue microarrays expression of membranous, cytoplasmic and nuclear tumour cell phosphorylation of FAK at Y397, Y861 and Y925 was assessed, and associations with clinicopathological characteristics, tumour microenvironment and cancer-specific survival (CSS) were examined. RESULTS No significant association was observed for ph-FAK Y861 with survival at all sites. However, high expression of membranous ph-FAK Y397 was associated with increased tumour grade (P < .001), molecular subtypes (P < .001), increased tumour necrosis (P < .001), high Klintrup-Mäkinen grade (P < .001), increased CD138+ plasma cells (P = .031), endocrine therapy (P = .001) and poor cancer specific survival (P = .040). Similarly, high expression of nuclear ph-FAK Y397 was associated with decreased age (P = .042), increased CD138+ plasma cells (P = .001) and poor cancer specific survival (P = .003). Furthermore, high expression of cytoplasmic ph-FAK Y925 was associated with decreased tumour grade (P < .001), less involved lymph node (P = .020), molecular subtypes (P < .001), decreased tumour necrosis (P < .001), low Klintrup-Mäkinen grade (P < .001), decreased CD4+ T-cells (P = .006), decreased CD138+ plasma cells (P = .034), endocrine therapy (P < .001), chemotherapy (P = .048), and improved cancer specific survival (P = .044). On multivariate analysis, high expression of nuclear ph-FAK Y397 was independently associated with reduced cancer specific survival (P = .017). CONCLUSION The results of the present study show that membranous and nuclear ph-FAK Y397 and cytoplasmic ph-FAK Y925 were associated with prognosis in patients with primary operable ductal breast cancer. In addition, high expression of nuclear ph-FAK Y397 was an independent prognostic factor in patients with primary operable ductal breast cancer and could be incorporated into clinical practice.
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Affiliation(s)
- Najla M Andisha
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences-University of Glasgow, Royal Infirmary, Glasgow, UK; Unit of Gastrointestinal cancer and Molecular Pathology, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK.
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences-University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Fadia J A Gujam
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences-University of Glasgow, Royal Infirmary, Glasgow, UK; Unit of Gastrointestinal cancer and Molecular Pathology, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK
| | - Antonia Roseweir
- Unit of Gastrointestinal cancer and Molecular Pathology, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK
| | - Joanne Edwards
- Unit of Gastrointestinal cancer and Molecular Pathology, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK
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39
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Brieu N, Gavriel CG, Nearchou IP, Harrison DJ, Schmidt G, Caie PD. Automated tumour budding quantification by machine learning augments TNM staging in muscle-invasive bladder cancer prognosis. Sci Rep 2019; 9:5174. [PMID: 30914794 PMCID: PMC6435679 DOI: 10.1038/s41598-019-41595-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
Tumour budding has been described as an independent prognostic feature in several tumour types. We report for the first time the relationship between tumour budding and survival evaluated in patients with muscle invasive bladder cancer. A machine learning-based methodology was applied to accurately quantify tumour buds across immunofluorescence labelled whole slide images from 100 muscle invasive bladder cancer patients. Furthermore, tumour budding was found to be correlated to TNM (p = 0.00089) and pT (p = 0.0078) staging. A novel classification and regression tree model was constructed to stratify all stage II, III, and IV patients into three new staging criteria based on disease specific survival. For the stratification of non-metastatic patients into high or low risk of disease specific death, our decision tree model reported that tumour budding was the most significant feature (HR = 2.59, p = 0.0091), and no clinical feature was utilised to categorise these patients. Our findings demonstrate that tumour budding, quantified using automated image analysis provides prognostic value for muscle invasive bladder cancer patients and a better model fit than TNM staging.
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Affiliation(s)
- Nicolas Brieu
- Definiens AG, Bernhard-Wicki-Straße 5, 80636, München, Germany
| | - Christos G Gavriel
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - Ines P Nearchou
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - David J Harrison
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK
| | - Günter Schmidt
- Definiens AG, Bernhard-Wicki-Straße 5, 80636, München, Germany
| | - Peter D Caie
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK.
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40
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Zhang S, Wang X, Gupta A, Fang X, Wang L, Zhang C. Expression of IL-17 with tumor budding as a prognostic marker in oral squamous cell carcinoma. Am J Transl Res 2019; 11:1876-1883. [PMID: 30972211 PMCID: PMC6456524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/11/2019] [Indexed: 06/09/2023]
Abstract
We evaluated the relationship between IL-17 expression and tumor budding in the oral squamous cell carcinoma (OSCC) tumor invasion front (TIF). We also analyzed the correlation between OSCC prognosis and the co-expression of IL-17 and tumor budding. We obtained tumor tissues, tumor margins, and adjacent normal tissues from a total of 80 patients with OSCC. We measured IL-17 expression by ELISA and performed hematoxylin and eosin (H&E) and immunohistochemical staining to evaluate the presentation of tumor budding and IL-17 expression in the TIF. IL-17 expression was significantly increased in the tumor tissues and margins compared with that in the normal tissues, which was confirmed by immunohistochemical staining. There were correlations between IL-17-positive tumor budding and T classification, lymph node metastasis, distant metastasis, clinical stage, and recurrence. In a multivariate survival analysis, the IL-17-positive tumor budding, besides tumor budding alone, was highly correlated with prognosis. Our results demonstrate a positive relationship between IL-17 expression and tumor budding in the OSCC TIF. IL-17 combined with tumor budding can serve as a valuable predictor of prognosis for patients with OSCC.
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Affiliation(s)
- Shijian Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of MedicineShanghai, China
- National Clinical Research Center for Oral DiseasesShanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of StomatologyShanghai, China
| | - Xudong Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of MedicineShanghai, China
- National Clinical Research Center for Oral DiseasesShanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of StomatologyShanghai, China
| | - Anand Gupta
- Department of Dentistry, Government Medical College and HospitalChandigarh, India
| | - Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska InstituteStockholm 17177, Sweden
| | - Lei Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of MedicineShanghai, China
- National Clinical Research Center for Oral DiseasesShanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of StomatologyShanghai, China
| | - Chenping Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of MedicineShanghai, China
- National Clinical Research Center for Oral DiseasesShanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of StomatologyShanghai, China
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41
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Nearchou IP, Lillard K, Gavriel CG, Ueno H, Harrison DJ, Caie PD. Automated Analysis of Lymphocytic Infiltration, Tumor Budding, and Their Spatial Relationship Improves Prognostic Accuracy in Colorectal Cancer. Cancer Immunol Res 2019; 7:609-620. [PMID: 30846441 DOI: 10.1158/2326-6066.cir-18-0377] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/15/2018] [Accepted: 01/24/2019] [Indexed: 11/16/2022]
Abstract
Both immune profiling and tumor budding significantly correlate with colorectal cancer patient outcome but are traditionally reported independently. This study evaluated the association and interaction between lymphocytic infiltration and tumor budding, coregistered on a single slide, in order to determine a more precise prognostic algorithm for patients with stage II colorectal cancer. Multiplexed immunofluorescence and automated image analysis were used for the quantification of CD3+CD8+ T cells, and tumor buds (TBs), across whole slide images of three independent cohorts (training cohort: n = 114, validation cohort 1: n = 56, validation cohort 2: n = 62). Machine learning algorithms were used for feature selection and prognostic risk model development. High numbers of TBs [HR = 5.899; 95% confidence interval (CI) 1.875-18.55], low CD3+ T-cell density (HR = 9.964; 95% CI, 3.156-31.46), and low mean number of CD3+CD8+ T cells within 50 μm of TBs (HR = 8.907; 95% CI, 2.834-28.0) were associated with reduced disease-specific survival. A prognostic signature, derived from integrating TBs, lymphocyte infiltration, and their spatial relationship, reported a more significant cohort stratification (HR = 18.75; 95% CI, 6.46-54.43), than TBs, Immunoscore, or pT stage. This was confirmed in two independent validation cohorts (HR = 12.27; 95% CI, 3.524-42.73; HR = 15.61; 95% CI, 4.692-51.91). The investigation of the spatial relationship between lymphocytes and TBs within the tumor microenvironment improves accuracy of prognosis of patients with stage II colorectal cancer through an automated image analysis and machine learning workflow.
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Affiliation(s)
- Ines P Nearchou
- Quantitative and Digital Pathology, School of Medicine, University of St. Andrews, St. Andrews, UK.
| | | | - Christos G Gavriel
- Quantitative and Digital Pathology, School of Medicine, University of St. Andrews, St. Andrews, UK
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Saitama, Japan
| | - David J Harrison
- Quantitative and Digital Pathology, School of Medicine, University of St. Andrews, St. Andrews, UK
| | - Peter D Caie
- Quantitative and Digital Pathology, School of Medicine, University of St. Andrews, St. Andrews, UK
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Yu P, Wang W, Zhuang Z, Xie N, Xu J, Wang C, Hou J, Han X, Liu X. A novel prognostic model for tongue squamous cell carcinoma based on the characteristics of tumour and its microenvironment: iBD score. Histopathology 2019; 74:766-779. [PMID: 30444275 DOI: 10.1111/his.13790] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 11/12/2018] [Indexed: 01/08/2023]
Abstract
AIMS Tumour budding and invasive depth can predict survival of patients with tongue squamous cell carcinoma (TSCC), while the prognostic value of tumour microenvironment (TME) remains unknown. Here, both characteristics of the tumour and its microenvironment were examined and a novel prognostic model has been proposed. METHODS AND RESULTS A total of 246 patients with TSCC were included. Using H&E-stained sections, pathological parameters of tumour and the TME were assessed. Inflammatory response (i), tumour budding (B) and invasive depth (D) were combined as iBD score. The association between these variables and the patient survival was determined. Both tumour budding and inflammatory status were independent variables for predicting overall survival (OS) and disease-free survival (DFS) of TSCC patients. Invasive depth was correlated with differentiation, T classification, lymph node metastasis, clinical stage and recurrence (P < 0.05). The novel iBD model was strongly correlated with T classification, lymph node metastasis, clinical stage and recurrence, and showed clear distinction of scores 0, 1 and 2. High iBD score had a strong association with reduced OS and DFS (P < 0.01). CONCLUSIONS The iBD scoring model is strongly associated with lymph node metastasis and recurrence in TSCC and could be a promising survival predictor for TSCC patients.
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Affiliation(s)
- Pei Yu
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Weiwang Wang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Zehang Zhuang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Nan Xie
- Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China.,Department of Oral Pathology, Guanghua School and Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Jieyun Xu
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Cheng Wang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Jingsong Hou
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
| | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, MA, USA.,Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, Boston, MA, USA
| | - Xiqiang Liu
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Oral Maxillofacial Surgery, Guanghua School of Stomatology and Hospital of Stomatology, Guangzhou, China
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43
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Zhu Y, Liu H, Xie N, Liu X, Huang H, Wang C, Hou J. Impact of tumor budding in head and neck squamous cell carcinoma: A meta‐analysis. Head Neck 2018; 41:542-550. [PMID: 30549142 DOI: 10.1002/hed.25462] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 06/11/2018] [Accepted: 08/22/2018] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yue Zhu
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
| | - Haichao Liu
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
| | - Nan Xie
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
- Department of Oral PatholgoyGuanghua School of Stomatology, Hospital of Stomatology Guangzhou China
| | - Xiqiang Liu
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
| | - Hongzhang Huang
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
| | - Cheng Wang
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
| | - Jinsong Hou
- Department of Oral and Maxillofacial SurgeryGuanghua School of Stomatology, Hospital of Stomatology, Sun Yat‐sen University Guangzhou China
- Guangdong Provincial Key Laboratory of StomatologySun Yat‐sen University Guangzhou China
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44
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Voutsadakis IA. Prognostic role of tumor budding in breast cancer. World J Exp Med 2018; 8:12-17. [PMID: 30211020 PMCID: PMC6134264 DOI: 10.5493/wjem.v8.i2.12] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/04/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023] Open
Abstract
Tumor budding, defined as a small number of cancer cells observed in pathology sections detached from the main tumor mass, is a common phenomenon in cancer. It is suggested that cells in buds are in the process of actively moving away from the primary tumor in the first step of metastasis. Tumor budding has been observed in a variety of carcinomas and is best studied in colorectal cancers where it portends poor prognosis. More recently, tumor budding was found to be of prognostic significance in other cancers including breast cancer. Tumor budding in breast cancer is associated with other adverse pathologic factors, such as larger tumor size and lymphovascular invasion, but may have additional independent prognostic value. In the future, standardization of the quantification criteria for tumor budding may further aid in its adoption as a prognostic marker.
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Affiliation(s)
- Ioannis A Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, Ontario, Canada; and Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, P3E 2C6, Canada
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45
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Natal RA, Vassallo J, Paiva GR, Pelegati VB, Barbosa GO, Mendonça GR, Bondarik C, Derchain SF, Carvalho HF, Lima CS, Cesar CL, Sarian LO. Collagen analysis by second-harmonic generation microscopy predicts outcome of luminal breast cancer. Tumour Biol 2018; 40:1010428318770953. [DOI: 10.1177/1010428318770953] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Second-harmonic generation microscopy represents an important tool to evaluate extracellular matrix collagen structure, which undergoes changes during cancer progression. Thus, it is potentially relevant to assess breast cancer development. We propose the use of second-harmonic generation images of tumor stroma selected on hematoxylin and eosin–stained slides to evaluate the prognostic value of collagen fibers analyses in peri and intratumoral areas in patients diagnosed with invasive ductal breast carcinoma. Quantitative analyses of collagen parameters were performed using ImageJ software. These parameters presented significantly higher values in peri than in intratumoral areas. Higher intratumoral collagen uniformity was associated with high pathological stages and with the presence of axillary lymph node metastasis. In patients with immunohistochemistry-based luminal subtype, higher intratumoral collagen uniformity and quantity were independently associated with poorer relapse-free and overall survival, respectively. A multivariate response recursive partitioning model determined 12.857 and 11.894 as the best cut-offs for intratumoral collagen quantity and uniformity, respectively. These values have shown high sensitivity and specificity to differentiate distinct outcomes. Values of intratumoral collagen quantity and uniformity exceeding the cut-offs were strongly associated with poorer relapse-free and overall survival. Our findings support a promising prognostic value of quantitative evaluation of intratumoral collagen by second-harmonic generation imaging mainly in the luminal subtype breast cancer.
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Affiliation(s)
- Rodrigo A Natal
- Laboratory of Investigative and Molecular Pathology, Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - José Vassallo
- Laboratory of Investigative and Molecular Pathology, Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Geisilene R Paiva
- Laboratory of Experimental Pathology (LAPE), CAISM—Women’s Hospital, State University of Campinas, Campinas, Brazil
| | - Vitor B Pelegati
- Department of Quantum Eletronics, “Gleb Wataghin” Institute of Physics, State University of Campinas, Campinas, Brazil
- INFABIC—National Institute of Science and Technology on Photonics Applied to Cell Biology, Campinas, Brazil
| | - Guilherme O Barbosa
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, Brazil
| | - Guilherme R Mendonça
- Laboratory of Investigative and Molecular Pathology, Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Caroline Bondarik
- Laboratory of Investigative and Molecular Pathology, Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Sophie F Derchain
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences and CAISM—Women’s Hospital, State University of Campinas, Campinas, São Paulo, Brazil
| | - Hernandes F Carvalho
- INFABIC—National Institute of Science and Technology on Photonics Applied to Cell Biology, Campinas, Brazil
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, Brazil
| | - Carmen S Lima
- Oncology Section, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Carlos L Cesar
- Department of Quantum Eletronics, “Gleb Wataghin” Institute of Physics, State University of Campinas, Campinas, Brazil
- INFABIC—National Institute of Science and Technology on Photonics Applied to Cell Biology, Campinas, Brazil
| | - Luís Otávio Sarian
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences and CAISM—Women’s Hospital, State University of Campinas, Campinas, São Paulo, Brazil
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46
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Miyake M, Hori S, Morizawa Y, Tatsumi Y, Toritsuka M, Ohnishi S, Shimada K, Furuya H, Khadka VS, Deng Y, Ohnishi K, Iida K, Gotoh D, Nakai Y, Inoue T, Anai S, Torimoto K, Aoki K, Tanaka N, Konishi N, Fujimoto K. Collagen type IV alpha 1 (COL4A1) and collagen type XIII alpha 1 (COL13A1) produced in cancer cells promote tumor budding at the invasion front in human urothelial carcinoma of the bladder. Oncotarget 2018; 8:36099-36114. [PMID: 28415608 PMCID: PMC5482641 DOI: 10.18632/oncotarget.16432] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/15/2017] [Indexed: 12/12/2022] Open
Abstract
Current knowledge of the molecular mechanism driving tumor budding is limited. Here, we focused on elucidating the detailed mechanism underlying tumor budding in urothelial cancer of the bladder. Invasive urothelial cancer was pathologically classified into three groups as follows: nodular, trabecular, and infiltrative (tumor budding). Pathohistological analysis of the orthotopic tumor model revealed that human urothelial cancer cell lines MGH-U3, UM-UC-14, and UM-UC-3 displayed typical nodular, trabecular, and infiltrative patterns, respectively. Based on the results of comprehensive gene expression analysis using microarray (25 K Human Oligo chip), we identified two collagens, COL4A1 and COL13A1, which may contribute to the formation of the infiltrative pattern. Visualization of protein interaction networks revealed that proteins associated with connective tissue disorders, epithelial-mesenchymal transition, growth hormone, and estrogen were pivotal factors in tumor cells. To evaluate the invasion pattern of tumor cells in vitro, 3-D collective cell invasion assay using Matrigel was performed. Invadopodial formation was evaluated using Gelatin Invadopodia Assay. Knockdown of collagens with siRNA led to dramatic changes in invasion patterns and a decrease in invasion capability through decreased invadopodia. The in vivo orthotopic experimental model of bladder tumors showed that intravesical treatment with siRNA targeting COL4A1 and COL13A1 inhibited the formation of the infiltrative pattern. COL4A1 and COL13A1 production by cancer cells plays a pivotal role in tumor invasion through the induction of tumor budding. Blocking of these collagens may be an attractive therapeutic approach for treatment of human urothelial cancer of the bladder.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Yoshihiro Tatsumi
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan.,Department of Pathology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Michihiro Toritsuka
- Department of Psychiatry, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Sayuri Ohnishi
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Keiji Shimada
- Department of Pathology, Nara City Hospital, Nara-shi, Nara, 630-8305, Japan
| | - Hideki Furuya
- Clinical and Translational Research Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Vedbar S Khadka
- Bioinformatics Core, Department of Complementary and Integrative Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA
| | - Youping Deng
- Bioinformatics Core, Department of Complementary and Integrative Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA
| | - Kenta Ohnishi
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Kota Iida
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Takeshi Inoue
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Satoshi Anai
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Katsuya Aoki
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Noboru Konishi
- Department of Pathology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara-shi, Nara 634-8522, Japan
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47
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Gujam FJA, McMillan DC, Edwards J. The relationship between total and phosphorylated STAT1 and STAT3 tumour cell expression, components of tumour microenvironment and survival in patients with invasive ductal breast cancer. Oncotarget 2018; 7:77607-77621. [PMID: 27769057 PMCID: PMC5363608 DOI: 10.18632/oncotarget.12730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/03/2016] [Indexed: 12/31/2022] Open
Abstract
The aim of the present study was to examine the relationship between tumour cell expression of total and phosphorylated STAT1 (ph-STAT1) and STAT3 (ph-STAT-3), components of tumour microenvironment and survival in patients with invasive ductal breast cancer. Immunohistochemical analysis of total and ph-STAT1, and STAT3 were performed on tissue microarray of 384 breast cancer specimens. Tumour cell expression of STAT1 and STAT3 at both cytoplasmic and nuclear locations were combined and identified as STAT1/STAT3 tumour cell expression. These results were related to cancer specific survival (CSS) and phenotypic features of the tumour and the host. High ph-STAT1 and ph-STAT3 tumour cell expression were associated with increased ER (both P≤0.001) and PR (both P <0.05), reduced tumour grade (P=0.015 and P<0.001 respectively) and necrosis (both P=0.001). Ph-STAT1 was associated with increased general inflammatory infiltrate (P=0.007) and ph-STAT3 was associated with lower CD4+ infiltration (P=0.024). In multivariate survival analysis, only high ph-STAT3 tumour cell expression was a predictor of improved CSS (P=0.010) independent of other tumour and host-based factors. STAT1 and STAT3 tumour cell expression appeared to be an important determinant of favourable outcome in patients with invasive ductal breast cancer. The present results suggest that STAT1 and STAT3 may affect disease outcome through direct impact on tumour cells, counteracting aggressive tumour features, as well as interaction with the surrounding microenvironment.
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Affiliation(s)
- Fadia J A Gujam
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences-University of Glasgow, Royal Infirmary, Glasgow, Scotland.,Unit of Experimental Therapeutics, Institute of Cancer, College of Medical, Veterinary and Life Sciences-University of Glasgow, Wolfson Wohl Cancer Research Centre, Glasgow, Scotland
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences-University of Glasgow, Royal Infirmary, Glasgow, Scotland
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer, College of Medical, Veterinary and Life Sciences-University of Glasgow, Wolfson Wohl Cancer Research Centre, Glasgow, Scotland
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48
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Almangush A, Pirinen M, Heikkinen I, Mäkitie AA, Salo T, Leivo I. Tumour budding in oral squamous cell carcinoma: a meta-analysis. Br J Cancer 2018; 118:577-586. [PMID: 29190636 PMCID: PMC5830589 DOI: 10.1038/bjc.2017.425] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Tumour budding has been reported as a promising prognostic marker in many cancers. This meta-analysis assessed the prognostic value of tumour budding in oral squamous cell carcinoma (OSCC). METHODS We searched OvidMedline, PubMed, Scopus and Web of Science for articles that studied tumour budding in OSCC. We used reporting recommendations for tumour marker (REMARK) criteria to evaluate the quality of studies eligible for meta-analysis. RESULTS A total of 16 studies evaluated the prognostic value of tumour budding in OSCC. The meta-analysis showed that tumour budding was significantly associated with lymph node metastasis (odds ratio=7.08, 95% CI=1.75-28.73), disease-free survival (hazard ratio=1.83, 95% CI=1.34-2.50) and overall survival (hazard ratio=1.88, 95% CI=1.25-2.82). CONCLUSIONS Tumour budding is a simple and reliable prognostic marker for OSCC. Evaluation of tumour budding could facilitate personalised management of OSCC.
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Affiliation(s)
- Alhadi Almangush
- Department of Patholosgy, University of Helsinki, Haartmaninkatu 3, PO Box 21, Helsinki FIN-00014, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 8, PO Box 63, Helsinki FI-00014, Finland
- Institute of Dentistry, University of Misurata, PO Box 2478, Misurata, Libya
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki FIN-00014, Finland
- Helsinki Institute for Information Technology HIIT and Department of Mathematics and Statistics, University of Helsinki, Helsinki FIN-00014, Finland
- Department of Public Health, University of Helsinki, Helsinki FIN-00014, Finland
| | - Ilkka Heikkinen
- Department of Patholosgy, University of Helsinki, Haartmaninkatu 3, PO Box 21, Helsinki FIN-00014, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 8, PO Box 63, Helsinki FI-00014, Finland
| | - Antti A Mäkitie
- Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Kasarminkatu 11-13, Helsinki FI-00130, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 8, PO Box 63, Helsinki FI-00014, Finland
- Helsinki University Hospital, Helsinki FIN-00014, Finland
- Research Group of Cancer Research and Translational Medicine, Medical Faculty, University of Oulu, PO Box 5281, Oulu 90014, Finland
- Medical Research Center, Oulu University Hospital, Oulu 90220, Finland
| | - Ilmo Leivo
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, Turku 20520, Finland
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49
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Laedrach C, Salhia B, Cihoric N, Zlobec I, Tapia C. Immunophenotypic profile of tumor buds in breast cancer. Pathol Res Pract 2017; 214:25-29. [PMID: 29254793 PMCID: PMC7474545 DOI: 10.1016/j.prp.2017.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Tumor buds are associated with lympho-vascular invasion and lymph node metastases leading to the assumption that they are involved in the early metastatic process. Hence, it would be important to know if tumor buds can be targeted with the most widely used targeted therapies in breast cancer (BC) and if changes in hormone and Her2 status occur. The aim of this study was to answer these questions by determining whether hormone receptor (HR) and Her2 status are expressed in the tumor buds of a large cohort of BCs. DESIGN We constructed a tumor bud next-generation tissue microarray (ngTMA) consisting of n = 199 BCs of non-special type. Generally, two 1 mm punches were taken from the tumor bud areas in the periphery (PTB) and within the tumor center (ITB). HR and Her2 status was assessed using immunohistochemistry and fluorescence in situ hybridization, respectively. HR status was positive if ≥1% of tumor bud cells were positive. Her2 status was considered positive if bud cells showed strong complete membranous Her2 over-expression or Her2 amplification. RESULTS Most tumor buds were positive for estrogen (ER) (PTB: 86%; ITB: 88.3) and progesterone receptor (PgR) (PTB: 72%; ITB: 72.8%) and Her2 was positive in: PTB 11.5% and ITB 11%. A difference between the main tumor mass and tumor buds (PTB and ITB) was seen for PgR in 3.5% of cases (n = 7). No differences were seen for ER and Her2 between tumor buds and main tumor mass. CONCLUSION Most tumor buds (96.5%) share the same HR and Her2 expression profile of the main tumor mass, implying that tumor buds relay on the same pathways as the main tumor mass and might be equally responsive to targeted therapies.
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Affiliation(s)
- C Laedrach
- Intstitute of Pathology, University of Bern, Bern, Switzerland
| | - B Salhia
- Department of Translational Genomics, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - N Cihoric
- Department of Radio-Oncology, Inselspital, Bern, Switzerland; Breast Center, Inselspital, Bern, Switzerland
| | - I Zlobec
- Intstitute of Pathology, University of Bern, Bern, Switzerland
| | - C Tapia
- Intstitute of Pathology, University of Bern, Bern, Switzerland; Breast Center, Inselspital, Bern, Switzerland; Department of Molecular Pathology, UT MD Anderson Cancer Center, Houston, TX, USA; Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, TX, USA.
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50
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Pedersen NJ, Jensen DH, Lelkaitis G, Kiss K, Charabi B, Specht L, von Buchwald C. Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma. Oncotarget 2017; 8:18227-18237. [PMID: 28212555 PMCID: PMC5392322 DOI: 10.18632/oncotarget.15314] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/30/2016] [Indexed: 11/25/2022] Open
Abstract
It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method to evaluate the predictive value of tumor budding. We developed a semi-automated image-analysis algorithm, Digital Tumor Bud Count (DTBC), to evaluate tumor budding. The algorithm was tested in 222 consecutive patients with early-stage OSCC and major endpoints were overall (OS) and progression free survival (PFS). We subsequently constructed and cross-validated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able to identify patients with occult lymph node metastases with an area under the curve (AUC) of 0.83 (95% CI: 0.78–0.89, P <0.001) and a 10-fold cross-validated AUC of 0.79. Compared to other known histopathological risk factors, the DTBC had a higher diagnostic accuracy. The proposed, novel risk model could be used as a guide to identify patients who would benefit from an up-front neck dissection.
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Affiliation(s)
- Nicklas Juel Pedersen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - David Hebbelstrup Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Giedrius Lelkaitis
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Birgitte Charabi
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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