Tumor Budding and Poorly Differentiated Clusters in Small Intestinal Adenocarcinomaopen access
- Authors
- Jun, Sun-Young; Chung, Joon-Yong; Yoon, Nara; Jung, Eun Sun; Oh, Young-Ha; Hong, Seung-Mo
- Issue Date
- Aug-2020
- Publisher
- MDPI
- Keywords
- small intestine; adenocarcinoma; tumor budding; poorly differentiated clusters; prognosis
- Citation
- CANCERS, v.12, no.8, pp.1 - 16
- Indexed
- SCIE
SCOPUS
- Journal Title
- CANCERS
- Volume
- 12
- Number
- 8
- Start Page
- 1
- End Page
- 16
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/142599
- DOI
- 10.3390/cancers12082199
- ISSN
- 2072-6694
- Abstract
- The clinicopathologic and prognostic significances of tumor budding (TB) and poorly-differentiated clusters (PDC) have not been investigated in small intestinal adenocarcinomas (SIACs). In 236 surgically-resected SIACs, we counted TB (single cells or clusters ≤4 tumor cells) and PDC (clusters ≥5 tumor cells) at the peritumoral-invasive front (p) and in the intratumoral area (i) independently to classify as grade-1 (≤4), grade-2 (5–9), or grade-3 (≥10). Consequently, grades-2 and -3 were considered high-grade. High-pTB, -iTB, -pPDC, and -iPDC were observed in 174 (73.7%), 129 (54.7%), 118 (50.0%), and 85 (36.0%) cases, respectively. High-TB/PDCs were more frequently observed in tumors with high-grade, higher T- and N-categories and stage grouping, and perineural or lymphovascular invasion. Patients with high-TB/PDC had a shorter survival than those with low-TB/PDC. In a multivariate analysis, high-pTB, nonintestinal type, high N-category, retroperitoneal seeding, and microsatellite-stable were worse independent-prognostic predictors. Subgroup analysis demonstrated that patients with high-pTB showed worse survival (median: 42.5 months) than those with low-pTB (133.7 months; p = 0.007) in the lower stage (stages I–II) group. High-TB/PDC, both in peritumoral and intratumoral localizations, were associated with aggressive behaviors in SIACs. High-pTB can be used as an adverse prognostic indicator in SIAC patients, especially when patients are in early disease stages.
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