title: Prognostic value of immunohistochemical analysis of tumor budding in colorectal carcinoma.
abstract: BACKGROUND
  Tumor 'budding' of colorectal carcinoma along the invasive margin has been associated with increased malignant potential. This study investigated the possible prognostic significance of budding in invasive colorectal carcinoma.
  
  
  METHODS
  Specimens resected from 149 patients who underwent potentially curative surgery for invasive colorectal carcinoma were studied. Budding was defined according to Ueno's criteria; budding intensity was assessed by examination of hematoxylin-eosin (HE)-stained specimens and immunohistochemical (IHC)-stained specimens using anti-cytokeratin antibody and anti-lymphatic vessel antibody.
  
  
  RESULTS
  Immunohistochemical analysis identified many more budding foci that were not detectable by examination of HE-stained specimens. Multivariate analyses revealed that budding identified using immunohistochemical staining was a significant prognostic marker for disease-free survival and there was significant correlation between budding and microlymphatic vessel infiltration at the invasive tumor front.
  
  
  CONCLUSIONS
  Budding, particularly as assessed with immunohistochemical staining, is a useful predictor of poor prognosis in patients with invasive colorectal carcinoma.
authors.affiliation: Department of Surgery, Nara Medical University, Kashihara-city, Nara, Japan. kenzou@zeus.eonet.ne.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ohtsuki
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.forename: Tomomi
authors.initials: T
authors.lastname: Tamura
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
authors.forename: Tomohide
authors.initials: T
authors.lastname: Mukogawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchimoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Akitaka
authors.initials: A
authors.lastname: Nonomura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000473:pathology*; D004801:Eosine Yellowish-(YS) / Q000737:chemistry; D005260:Female; D006416:Hematoxylin / Q000737:chemistry; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013194:Staining and Labeling / Q000379:methods
chemical_list: D004801:Eosine Yellowish-(YS); D006416:Hematoxylin