Differential prognostic significance of morphologic invasive markers in colorectal cancer: tumor budding and cytoplasmic podia.
OBJECTIVE
In colorectal cancer, the presence of cytoplasmic podia around tumor budding foci may be a morphologic marker for an activated budding phenotype that is associated with cell motility. In this study, we have investigated the prognostic significance of cytoplasmic podia.


METHODS
A total of 136 pT3 colorectal cancers were classified according to extent of budding and cytoplasmic podia as identified by immunostaining for cytokeratin. The prognostic significance of budding and cytoplasmic podia was then assessed.


RESULTS
The overall survival curves between the groups with high-grade and low-grade cytoplasmic podia were different (5-year survival rates were 60.5 and 83.8 percent respectively, P = 0.0003). Similar results were shown for tumor budding (59.8 and 87.7 percent, P < 0.0001). Multivariate analysis showed that the grades of cytoplasmic podia (hazards ratio, 2.4; P = 0.012) and budding (hazards ratio, 2.3; P = 0.024) were independent prognostic factors. Additionally, among colorectal cancers with high-grade budding, the grade of cytoplasmic podia was selected as an independent prognostic factor (hazards ratio, 2.4; P = 0.042).


CONCLUSIONS
Cytoplasmic podia and budding are related but independent pathologic predictive markers in patients with resected pT3 colorectal cancer.
Shinto
Eiji
E
Department of Pathology II, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. eiji-c@zf6.so-net.ne.jp
Jass
Jeremy R
JR
Tsuda
Hitoshi
H
Sato
Taichi
T
Ueno
Hideki
H
Hase
Kazuo
K
Mochizuki
Hidetaka
H
Matsubara
Osamu
O
D000368:Aged; D002465:Cell Movement; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000648:ultrastructure; D003593:Cytoplasm / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011554:Pseudopodia / Q000473:pathology*; D015996:Survival Rate