Affiliation:
1. Department of Hepatobiliary Surgery and Liver Transplantation The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi China
2. Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education Xi'an Shaanxi China
3. Department of Critical Care Nephrology and Blood Purification The First Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi China
4. Hangzhou Institute of National Extremely‐weak Magnetic Field Infrastructure Hangzhou Zhejiang China
5. Department of Surgical Intensive Care Units The First Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi China
Abstract
AbstractAimTumor budding (TB) has excellent prognostic value in many solid tumors, but there is little research on it in hepatocellular carcinoma (HCC). This study assessed the prognostic value of TB in patients with HCC who received hepatectomy.MethodsThis retrospective study included 210 patients with HCC who received curative hepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University, between 2016 and 2018. TB was evaluated on hematoxylin‐ and eosin‐stained slides according to the criteria established by the 2016 International Tumor Budding Consensus Conference. t‐tests, Chi‐squared tests, and rank‐sum tests were used to correlate the extent of TB with clinicopathological parameters. Prognostic analysis was performed using Cox regression models and the Kaplan–Meier method.ResultsThe positive detection rate of TB was 45.2% (95/210) in 210 patients with HCC. Patients positive for TB always exhibit lower tumor differentiation, higher hepatitis B virus DNA levels, and more severe liver fibrosis. Multivariate Cox analysis identified TB (hazard ratio [HR]: 2.232, 95% confidence interval [CI]: 1.479–3.368, p < 0.001) as an independent prognostic factor for patients' recurrence‐free survival (RFS), similar to tumor size (HR: 1.070, 95% CI: 1.070–1.142, p = 0.042) and satellite nodule (HR: 2.266, 95% CI: 1.298–3.956, p = 0.004). Kaplan–Meier analysis also demonstrated that TB‐positive patients had a significantly worse RFS. Interestingly, subgroup analysis revealed that among HCC patients with negative microvascular invasion (MVI), TB was also strongly associated with RFS (HR: 3.206, 95% CI: 1.667–6.168, p < 0.001). These findings suggest that TB may serve as a supplemental prognostic biomarker for HCC‐negative MVI.ConclusionsTB is an adverse prognostic biomarker for HCC, particularly in patients negative for MVI. TB evaluation should be considered in the postoperative pathological examination of HCC in clinical practice.