Prognostic value of immunohistochemical analysis of tumor budding in colorectal carcinoma.
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.
Ohtsuki
Kenichi
K
Department of Surgery, Nara Medical University, Kashihara-city, Nara, Japan. kenzou@zeus.eonet.ne.jp
Koyama
Fumikazu
F
Tamura
Tomomi
T
Enomoto
Yasunori
Y
Fujii
Hisao
H
Mukogawa
Tomohide
T
Nakagawa
Tadashi
T
Uchimoto
Kazuaki
K
Nakamura
Shinji
S
Nonomura
Akitaka
A
Nakajima
Yoshiyuki
Y
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
D004801:Eosine Yellowish-(YS); D006416:Hematoxylin