Evaluation And Applicability Of Tumour Budding And Poorly Differentiated Clusters As Additional Prognostic Markers In Colorectal Cancers

Abstract

Abstract Purpose Very few studies have assessed Tumour budding (TB) and poorly differentiated cell clusters (PDC) simultaneously in colorectal cancers (CRCs). The goal of this study is to establish a correlation between these two pertinent histological features and to reinforce the importance of their incorporation in routine histopathological reporting of CRC cases as a means to predict clinical outcome. Methods Resection specimens of colorectal carcinoma were included in the study. Patients who received presurgical therapy, or refused consent were excluded. PDC and TB were evaluated in routine haematoxylin and eosin stained histopathological sections taken from the advancing edge of the tumor. TB and PDC were reported by selecting a “hotspot” chosen after review of all available slides with invasive tumor. It was then followed by their correlation with other known prognostic factors. Results Spearman’s Rho calculator for strength of association between TB & PDC as well as association of TB and PDC individually with known prognostic factors revealed statistical significance. Correlation of TB and PDC with histologic grade, primary tumor (pT) and regional lymph node (pN) stage was done based on One-Way ANOVA Calculator, which yielded statistically significant results. Conclusion Evaluation of these two histological parameters in the same hotspot field at the tumor invasive front, plays a fundamental role in the definition of cancer aggressiveness and prediction of tumor behaviour.