Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Max, N.
Tumour budding with and without admixed inflammation in colorectal cancer
A systematic clinicopathological analysis
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Langner Cord
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- Abstract:
- Background: In colorectal cancer, the morphology at the invasive tumour margin is known to reflect the biology of disease, rendering important prognostic information. Tumour budding, defined as the presence of isolated single cells or small clusters of cells (composed of fewer than five cells), has been associated with adverse outcome in colorectal cancer. In contrast, peritumoral inflammation has been associated with favourable outcome. Of note, the anti-tumour activity of inflammation may lead to the destruction of tumour glands and, ultimately, the presence of small clusters of cells scattered in the tumour stroma. Methods: Colorectal cancers of 381 randomly selected patients were retrospectively reviewed for the extent of tumour budding and peritumoral inflammation. Both parameters were related to various clinicopathological features using univariate and multivariate analyses. Progression-free and cancer-specific survivals were determined using the Kaplan-Meier method. Results: Tumour budding and overall inflammation in colorectal cancer was significantly associated with both progression-free and cancer-specific survival in our cohort. Cases with high grade budding and marked inflammation had a better outcome regarding progression-free (p<0.001) and cancer-specific survival (p<0.001) than high grade cases with only mild inflammation. Outcome in these cases, however, was still worse compared to cases with low grade budding, in which the extent of peritumoral inflammation had no further prognostic effect. Conclusions: Though tumours with marked inflammation at the invasive tumour margin may show destruction of cancer islands due to the anti-tumour effect of the inflammatory infiltrate, the presence of isolated tumour cells and small clusters of cells scattered in the stroma at the tumour margin does not per se imply favourable outcome in these cases. It is of note that tumours with high grade budding and marked inflammation at the invasion front still bear a significantly poorer outcome than tumours with low grade budding, in which the extent of peritumoral inflammation had no prognostic effect. Validation of our findings by other independent centres is desirable.