Tumor Budding Is an Objective High-risk Factor Associated With Metastasis and Poor Clinical Prognosis in Cutaneous Squamous Cell Carcinoma Sized <4 cm
| Autor: | Kohei Ogawa, Masatoshi Jinnin, Toshihiro Takai, Yuki Yamamoto, Yoshifumi Iwahashi, Yuichi Takahashi, Shin-ichi Murata, Fumiyoshi Kojima, Kenji Warigaya, Takanori Yoshikawa, Masakazu Fujimoto, Noriki Fujimoto, Ibu Matsuzaki |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Skin Neoplasms Cutaneous squamous cell carcinoma Biopsy Risk Assessment Pathology and Forensic Medicine Metastasis 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Japan Tumor budding Cell Movement Predictive Value of Tests Risk Factors Carcinoma Humans Medicine Neoplasm Invasiveness Risk factor Aged Retrospective Studies Aged 80 and over Observer Variation Neoplasm Grading medicine.diagnostic_test business.industry Reproducibility of Results Retrospective cohort study Middle Aged medicine.disease Tumor Burden Lymphatic Metastasis 030220 oncology & carcinogenesis Carcinoma Squamous Cell Cancer research Female Surgery Anatomy business |
| Zdroj: | American Journal of Surgical Pathology. 43:975-983 |
| ISSN: | 0147-5185 |
| DOI: | 10.1097/pas.0000000000001284 |
| Popis: | Although most cases of early cutaneous squamous cell carcinoma (CSCC) are indolent, a small subset metastasize and can be fatal. However, high-risk features of CSCC are controversial, and it is difficult to predict the biological behavior. In this study, we have tested the prognostic significance of tumor budding in CSCCs4 cm in diameter. Hematoxylin and eosin-stained sections of surgically resected CSCCs (24 metastasizing and 24 nonmetastasizing cases)4 cm in size were reviewed retrospectively. Tumor bud, defined as an isolated cancer cell or a cluster comprising5 cells, was counted at a hot spot (1.23 mm), and graded between 1 and 3; grade 1: 0 to 4 buds; grade 2: 5 to 9 buds; and grade 3: ≥10 buds. Cases with grades 2 or 3 were regarded as positive for tumor budding. We found that tumor budding was positive in 83.3% of metastasizing CSCC, and 37.5% of nonmetastasizing CSCC (P0.01). Moreover, CSCCs with grade 3 tumor budding showed worse disease-specific survival (P0.01). Regarding interobserver reproducibility, the median κ value for tumor budding was significantly higher than that for histologic differentiation (P0.01). In conclusion, tumor budding may be a valuable histologic marker for risk stratification of early CSCC in routine practice. Patients with tumor budding positive CSCC may benefit from evaluation and close follow-up for regional node metastasis. |
| Databáze: | OpenAIRE |
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