Reporting of tumor budding in colorectal adenocarcinomas using ×40 objective: A practical approach for resource constrained set-ups
| Autor: | Manas Kumar Roy, Indranil Mallick, Paromita Roy, Jayati Datta, Mallath Mohandas |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Mandatory reporting Adolescent Colorectal cancer Concordance Resource constrained Kaplan-Meier Estimate Stage ii Adenocarcinoma Disease-Free Survival Tumor budding Internal medicine Medicine Humans Neoplasm Invasiveness High-power field Aged Neoplasm Staging Aged 80 and over business.industry Consensus conference Middle Aged medicine.disease Prognosis Female business Colorectal Neoplasms |
| Zdroj: | Indian journal of cancer. 54(4) |
| ISSN: | 1998-4774 |
| Popis: | CONTEXT: Tumor budding (TBud) is recognized as a poor prognostic marker in colorectal cancer (CRC) with important treatment implications in Stage II cancers and malignant polyps. There are multiple propositions for bud count reporting but without an uniformly accepted system. The International TBud consensus conference (ITBCC) proposed mandatory reporting of budding on the single worst ×20 high power field (0.785 mm2 area) with a 3-tier scoring system (low/intermediate/high for 0–4, 5–9, and ≥10 buds/×20 field). AIMS: Due to the lack of availability of ×20 objective, we aimed to validate a simple ×40 field count (0.236 mm2 area) for wider applicability. METHODS: Bud count was done on hematoxylin and eosin-stained slides of 92 archived cases of colon cancer on the worst ×20 and ×40 fields (0.95 mm2 and 0.236 mm2 area) (hotspot method). Count for 0.785 mm2 area was calculated using ITBCC normalization factor of 1.2. Interobserver variability between two observers was assessed. Score groups for ×20 field and proposed score groups for 40× field (low/intermediate/high for 0–1, 2–4 and ≥5 buds) were compared with disease-free survival. RESULTS: High bud score was seen in 20.6% and 31.5% cases, respectively, using the ×20 and ×40 methods. High interobserver concordance was noted (ICC 0.95). Both the ITBCC bud score and our proposed 40× scoring correlated significantly with prognosis (P = 0.030, log-rank test). CONCLUSIONS: In centers lacking 20× objective, we propose using the worst 40× hotspot method for reporting of budding for all CRCs as a simple, reproducible and prognostically significant scoring system. |
| Databáze: | OpenAIRE |
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