Intra-Tumoral Budding in Pre-Operative Biopsy Specimens Predicts Lymph Node and Distant Metastasis in Patients with Colorectal Cancer
Olivier T Giger, Sarah Comtesse, Alessandro Lugli, Inti Zlobec, Michael Kurrer. University of Berne, Berne, Switzerland; Cantonal Hospital Winterthur, Winterthur, Switzerland; Pathologie Institut Enge, Zurich, Switzerland
Background: Tumor budding (TB), the histological hallmark of the epithelial-mesenchymal transition (EMT) in colorectal cancer (CRC) is associated with tumor progression and is an independent prognostic factor. Alltough current definitions for TB are reserved for the invasive tumor front in CRCs, “tumor budds” can be observed in small preoperative biopsy specimens. Whereas the prognostic value of TB assessed in resection specimens has found wide acceptance, its value in preoperative biopsies, which normally do not encompass the invasive margins of the tumor and hence are better categorized as intra-tumoral budding, has not been systematically investigated yet. The aim of this study was to analyze the prognostic and predictive significance of ITB in preoperative biopsies.
Design: Preoperative biopsy samples, consecutive resection specimens from 72 patients were assessed for ITB in the biopsies and TB in the resection specimen. ITB and TB were scored semiquantitatively as high (detectable at low power magnification; 2.5x) and “not high” (occasional budding at intermediate magnification 10x, difficult to find or absent).
Results: High ITB was observed in biopsy samples of 12/72 patients (16.7.%). This was associated with high TB in resection specimen (11/12 patients, P=0.008), lymph node metastasis (10/12 patients, P=0.034) and distant metastasis (9/11 patients, P=0.007).
Conclusions: High ITB in preoperative biopsy specimen of CRC patients predicts high PTB at the invasive margin, lymph node and distant metastasis. Our data show that high ITB can be assessed in preoperative biopsy specimen of CRC and is of important prognostic and predictive value.
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 78, Tuesday Afternoon