Prognostic Significance of "High" Tumor Budding and "High" Poorly Differentiated Clusters in Endometrial Carcinomas: Independent Predictors of Lymphovascular Space Invasion and Lymph Node Metastasis.

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-07-29 DOI:10.1097/PGP.0000000000001061
Elina James, Gayatri Ravikumar, John Michael Raj A, Kiran Kulkarni
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Abstract

Tumor budding (TB) and poorly differentiated clusters (PDCs) are well-established prognostic factors in various cancers. This study aimed to assess the independent prognostic role of these markers in endometrial carcinomas. Retrospective analysis of endometrial carcinoma resection specimens by examining traditional histologic prognostic parameters. TB and PDC were observed at 20× magnification in ten fields at the invasive front and categorized as present or absent. In addition, a count of ≥5 was stratified as "high." Clinical and follow-up details were extracted from Gynecologic Oncology records. Sixty-five endometrial carcinomas were studied and were predominantly endometrioid (n=47, 72.3%). TB was identified in 52.3% of cases, with high TB observed in 38.5%. PDC was evident in 44.6%, with high PDC seen in 29.2%. Associations were significant between the presence of TB/high TB and higher tumor grade (P < 0.001), deep myometrial invasion (P = 0.006/P = 0.002), diffuse pattern of invasion (P = 0.007/P = 0.03), microcystic elongated and fragmented pattern (P < 0.001), lymphovascular space invasion, lymph node metastasis (P=<0.001) and International Federation of Gynecology and Obstetrics stage (P = 0.000/P = 0.002). PDC/high PDC showed similar associations, and, in addition, with nonendometrioid histologic type (P = 0.02) and tumor location in a lower uterine segment (high PDC, P = 0.009). After adjusting for other significant parameters, both high TB (P = 0.03) and high PDC (P = 0.031) emerged as independent prognostic parameters for lymphovascular space invasion or Lymph node metastasis. No recorded deaths or significant events occurred, precluding commentary on overall survival status. High TB and PDC are independent predictors of Lymph node metastasis in endometrial carcinomas. Their association with the microcystic elongated and fragmented pattern makes them histologic predictors of epithelial-mesenchymal transition. Their simple application underscores their potential as valuable additional prognostic indicators for endometrial carcinomas.

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子宫内膜癌中 "高 "肿瘤萌发和 "高 "分化差簇的预后意义:淋巴管间隙侵犯和淋巴结转移的独立预测因子
肿瘤萌芽(TB)和分化不良簇(PDC)是各种癌症中公认的预后因素。本研究旨在评估这些标志物在子宫内膜癌中的独立预后作用。通过检查传统的组织学预后参数,对子宫内膜癌切除标本进行回顾性分析。以 20 倍放大率在十个视野中观察浸润前沿的 TB 和 PDC,并将其分为存在或不存在。此外,计数≥5分为 "高"。从妇科肿瘤学记录中提取临床和随访细节。共研究了 65 例子宫内膜癌,以子宫内膜样癌为主(47 例,72.3%)。52.3%的病例发现了结核,38.5%的病例发现了高结核。44.6%的病例存在明显的 PDC,其中 29.2% 的病例存在高 PDC。TB/高TB的存在与较高的肿瘤分级(P < 0.001)、子宫肌层深部浸润(P = 0.006/P = 0.002)、弥漫性浸润模式(P = 0.007/P = 0.03)、微囊拉长和碎裂模式(P < 0.001)、淋巴管间隙浸润、淋巴结转移(P = 0.006/P = 0.002)之间存在明显的相关性。
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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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