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.

Patients and 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.

Conclusion: Budding, particularly as assessed with immunohistochemical staining, is a useful predictor of poor prognosis in patients with invasive colorectal carcinoma.