The prognostic significance of growth pattern, tumor budding, poorly differentiated clusters, desmoplastic reaction pattern and tumor-stroma ratio in colorectal cancer and an evaluation of their relationship with KRAS, NRAS, BRAF mutations

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology Pub Date : 2024-09-13 DOI:10.1016/j.anndiagpath.2024.152375

Duygu Unal Kocabey, I. Ebru Cakir

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引用次数: 0

Abstract

Growth pattern (GP), tumor budding (TB), poorly differentiated clusters (PDC), desmoplastic reaction pattern (DRP) and tumor-stroma ratio (TSR) are prognostic histomorphological parameters in colorectal cancer (CRC). Correlations between these parameters, their individual prognostic values, and their relationship with KRAS/NRAS/BRAF mutations have not been comprehensively examined. We aimed to investigate these associations, which have not been previously explored in this combination. 126 CRC cases were included. GP, TB, PDC, DRP and TSR were evaluated by two experienced pathologists. KRAS/NRAS/BRAF mutation profile were determined using qPCR. Demographic, clinicopathological and survival data were recorded. Interrelations were investigated by statistical analysis. Infiltrative GP was more frequent in high-score TB, PDC-G3, and stroma-high tumors (p < 0.05). High-score TB was more common in PDC-G3 and stroma-high tumors (p < 0.05). Immature DRP was more frequent in stroma-high tumors (p = 0.014). Among histomorphological parameters, a significant relationship was found only between infiltrative GP and the presence of KRAS mutation (p = 0.023). Moreover, GP was significantly associated with pT, lymphatic invasion, perineural invasion (p < 0.05). Effects on survival were assessed using Kaplan-Meier method and Cox proportional hazards model. TB and PDC were identified as independent predictors of overall survival. Higher TB score (p = 0.008) and higher PDC grade (p = 0.013) lead to worse survival. Interestingly, GP, DRP, TSR or KRAS/NRAS/BRAF mutations were not associated with overall survival. Our results highlight the prognostic significance of TB and PDC. We suggest incorporating TB and PDC into routine CRC reports. The association of KRAS mutation with infiltrative GP supports its role in the acquisition of invasive behavior.

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结直肠癌的生长模式、肿瘤出芽、分化不良簇、脱瘤反应模式和肿瘤间质比率的预后意义，以及它们与 KRAS、NRAS 和 BRAF 基因突变的关系评估。

生长模式（GP）、肿瘤出芽（TB）、分化不良簇（PDC）、去瘤细胞反应模式（DRP）和肿瘤-基质比（TSR）是结直肠癌（CRC）的预后组织形态学参数。这些参数之间的相关性、它们各自的预后价值以及它们与 KRAS/NRAS/BRAF 突变的关系尚未得到全面研究。我们的目的是研究这些相关性，以前从未在这种组合中进行过探讨。我们共纳入了 126 例 CRC 病例。两位经验丰富的病理学家对 GP、TB、PDC、DRP 和 TSR 进行了评估。KRAS/NRAS/BRAF 基因突变情况通过 qPCR 进行测定。记录了人口统计学、临床病理学和生存数据。统计分析研究了这些数据之间的相互关系。浸润性 GP 在高分 TB、PDC-G3 和基质高的肿瘤中更为常见（p

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来源期刊

Annals of Diagnostic Pathology 医学-病理学

CiteScore

3.90

自引率

5.00%

发文量

149

审稿时长

26 days

期刊介绍： A peer-reviewed journal devoted to the publication of articles dealing with traditional morphologic studies using standard diagnostic techniques and stressing clinicopathological correlations and scientific observation of relevance to the daily practice of pathology. Special features include pathologic-radiologic correlations and pathologic-cytologic correlations.