Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016
Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016
复制标题
DOI：
10.1038/modpathol.2017.46
复制
发表时间：
2017-09-01
期刊：
影响因子：
7.5
通讯作者：
Quirke, Phil
中科院分区：
文献类型：
--
作者：
Lugli, Alessandro;Kirsch, Richard;Quirke, Phil
肿瘤出芽是结直肠癌的一个公认的独立预后因素，但缺乏标准化的评估方法。国际肿瘤萌芽共识会议（ITBCC）的主要目的是就结直肠癌肿瘤萌芽的国际循证标准化评分系统达成一致。ITBCC包括九场会议，包括演讲，会前调查和一本电子书，涵盖了关于结直肠癌肿瘤萌芽的主要出版物。采用“推荐评估、开发和评价分级”方法确定推荐的强度和证据的质量。以下10种说法达成共识：肿瘤出芽定义为单个肿瘤细胞或由4个或更少肿瘤细胞组成的细胞簇（22/22，100%）。肿瘤出芽是pT 1结直肠癌淋巴结转移的独立预测因子（23/23，100%）。肿瘤出芽是II期结直肠癌生存率的独立预测因子（23/23，100%）。在多学科背景下，肿瘤出芽应与其他临床病理特征沿着考虑（23/23，100%）。肿瘤出芽在H&E上计数（19/22，86%）。结直肠癌中存在瘤内出芽，并已被证明与淋巴结转移有关（22/22，100%）。在侵入性前沿的一个热点（在测量为0.785 mm 2的视野中）评估肿瘤出芽（22/22，100%）。沿着使用三层系统和出芽计数，以便于对结直肠癌进行危险分层（23/23，100%）。肿瘤出芽与肿瘤分级不一致（23/23，100%）。肿瘤出芽应纳入结直肠癌报告指南/方案（23/23，100%）。ITBCC的成员能够就肿瘤萌芽评估和报告的单一国际循证方法达成强烈共识。建议将该方法纳入结直肠癌指南/方案和分期系统。
Tumor budding is a well-established independent prognostic factor in colorectal cancer but a standardized method for its assessment has been lacking. The primary aim of the International Tumor Budding Consensus Conference (ITBCC) was to reach agreement on an international, evidence-based standardized scoring system for tumor budding in colorectal cancer. The ITBCC included nine sessions with presentations, a pre-meeting survey and an e-book covering the key publications on tumor budding in colorectal cancer. The 'Grading of Recommendation Assessment, Development and Evaluation' method was used to determine the strength of recommendations and quality of evidence. The following 10 statements achieved consensus: tumor budding is defined as a single tumor cell or a cell cluster consisting of four tumor cells or less (22/22, 100%). Tumor budding is an independent predictor of lymph node metastases in pT1 colorectal cancer (23/23, 100%). Tumor budding is an independent predictor of survival in stage II colorectal cancer (23/23, 100%). Tumor budding should be taken into account along with other clinicopathological features in a multidisciplinary setting (23/23, 100%). Tumor budding is counted on H&E (19/22, 86%). Intratumoral budding exists in colorectal cancer and has been shown to be related to lymph node metastasis (22/22, 100%). Tumor budding is assessed in one hotspot (in a field measuring 0.785 mm2) at the invasive front (22/22, 100%). A three-tier system should be used along with the budding count in order to facilitate risk stratification in colorectal cancer (23/23, 100%). Tumor budding and tumor grade are not the same (23/23, 100%). Tumor budding should be included in guidelines/protocols for colorectal cancer reporting (23/23, 100%). Members of the ITBCC were able to reach strong consensus on a single international, evidence-based method for tumor budding assessment and reporting. It is proposed that this method be incorporated into colorectal cancer guidelines/protocols and staging systems.