title: Tumor budding and E-Cadherin expression in endometrial carcinoma: are they prognostic factors in endometrial cancer?
abstract: OBJECTIVE
  To evaluate the prognostic value of tumor budding (TB) in endometrioid (EEC) and non-endometrioid endometrial cancers (NEEC) and to determine its correlation with expression of E-cadherin.
  
  
  METHODS
  Ninety-five patients with primary endometrial carcinoma were examined statistically. All patients were diagnosed, treated, and given follow-up care at Dokuz Eylul University Faculty of Medicine. Tumor budding detected by either H&E-stained sections and anticytokeratin-staining C11. The tissue block with the largest invasive front was chosen for budding counting and immunostaining. E-cadherin expression was examined by immunohistochemistry using the primary antibodies against to it.
  
  
  RESULTS
  Tumor budding was low-grade in 73 and high-grade in 22 cases. E-cadherin expression loss was identified in 48 patients. The high-grade TB was significantly higher in patients with advanced stage and deep myometrial invasion (p=0.032 and 0.018, respectively). E-Cadherin expression was significantly lower in NEECs than EECs (p=0.032). The negative expression of E-cadherin was associated with advanced stage and poor differentiation (p=0.001 and p=0.024, respectively). We determined that tumor budding adversely correlated with the presence of E-cadherin expression but not statistically significant. Based on the results of multivariate analysis, TB has an independent impact on cumulative overall survival. We found no statistically significant difference between E-cadherin expression and survival.
  
  
  CONCLUSIONS
  TB is associated with undifferentiated tumor, advanced stage and decreased postoperative survival in endometrial cancer. It might be a valuable prognostic clinicopathologic factor which can be applicable in routine examination.
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Pathology, Izmir, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Koyuncuoglu
authors.forename: Emre
authors.initials: E
authors.lastname: Okyay
authors.forename: Bahadir
authors.initials: B
authors.lastname: Saatli
authors.forename: Safak
authors.initials: S
authors.lastname: Olgan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akin
authors.forename: Ugur
authors.initials: U
authors.lastname: Saygili
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015820:Cadherins / Q000378:metabolism*; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D015820:Cadherins