Tumor Budding as an Additional Factor in Determining the Need for Surgery after Endoscopic Resection in Mucosal Invasive Gastric Cancer: A Retrospective Study from a Korean Tertiary Hospital.
Yeonjin Je, Yuna Kim, Su-Jin Shin, Jie-Hyun Kim, Goeun Park, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, In Gyu Kwon
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引用次数: 0
Abstract
Background/aims: The presence of individual cancer cells at the invasive tumor front is referred to as tumor budding (TB). The purpose of this study was to assess the clinicopathological significance of TB in patients with early gastric cancer (EGC).
Methods: A total of 939 patients who received radical surgery for EGC were included in this retrospective study. We assessed clinicopathological features in relation to TB including the grade of histologic differentiation, the extent of invasion depth, the width of submucosal (SM) invasion, and the presence of lymphovascular invasion (LVI), lymph node metastasis (LNM) and perineural invasion (PNI).
Results: TB was identified in 59.5% of the patients with EGC, 38.7% of the patients with mucosal invasive cancer, and 80.4% of the patients with SM invasive cancers. TB showed significant association with male sex, undifferentiated tumor types, SM invasion, LVI, PNI, and LNM. The presence of SM invasion (odds ratio [OR], 8.750; p<0.001), TB (OR, 5.586; p<0.001), and an undifferentiated-type histology (OR, 2.648; p=0.0005) were found to be significantly associated with LNM/LVI. TB was the sole significant risk factor for LNM/LVI (OR, 7.181; p=0.0016) among the mucosal invasive cancers. In SM invasive cancers, three independent risk factors for LNM/LVI were identified: a tumor located in the lower third of the stomach (OR, 3.425; p=0.0061), an undifferentiated-type histology (OR, 2.320; p=0.0177), and an SM invasion width greater than 4,000 μm (OR, 2.849; p=0.0041).
Conclusions: TB may be an important factor associated with LNM, particularly in mucosal gastric cancer.
期刊介绍：
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology.
Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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