The prognostic value of tumor budding in intrahepatic cholangiocarcinoma

Objective To evaluate the role of tumor budding in the prognostic value of intrahepatic cholangiocarcinoma(ICC) after radical resection. Methods The clinicopathological data of patients undergoing radical resection for intrahepatic cholangiocarcinoma between 2011 and 2016 were retrospectively analyzed. The number of tumor budding was counted in a ×200 microscopic field (0.785mm2). Based on receiver operation curve (ROC), the number of tumor budding≥15 was defined as high-grade group, and<15 was low-grade group. Multivariate analysis were performed on predictors of the tumor. Results Low-grade group was observed in 32 cases and high-grade group in 50. High-grade group appeared to develop tumors with higher CA199, poor differentiation, larger tumor diameter, advanced stage and high risks of lymphnode metastasis(respectively χ2=5.470, 4.359, 5.101, 4.696, 5.960, all P<0.05). Univariate analysis showed that tumor budding, CA199, differentiation, tumor diameter, T classification and lymphnode metastasis were related to the overall survival of patients with ICC(respectively χ2=11.704, 4.876, 5.056, 5.152, 8.442, 16.725, all P<0.05). On multivariable analysis, high-grade group was a significant independent predictor of worse OS(HR=2.707 95% CI 1.558-4.705, P<0.001). Conclusions High-grade tumor budding is an important negative prognostic factor for ICC. Key words: Bile duct neoplasms; Prognosis