Tumor budding, a novel prognostic indicator for predicting stage progression in T1 bladder cancers.
Tumor budding, a novel prognostic indicator for predicting stage progression in T1 bladder cancers.
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DOI：
10.1111/cas.12990
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发表时间：
2016-09
期刊：
影响因子：
5.7
通讯作者：
Oya M
中科院分区：
文献类型：
--
作者：
Fukumoto K;Kikuchi E;Mikami S;Ogihara K;Matsumoto K;Miyajima A;Oya M
肿瘤出芽已被定义为孤立的单个癌细胞或由分散在基质中的少于五个癌细胞组成的簇。它是T1期结直肠癌淋巴结转移的强预测因子。我们将这一概念引入T1非肌层浸润性膀胱癌，并评估肿瘤出芽是否会对临床结局产生预后影响。我们确定了1994年至2014年期间在庆应义塾大学医院新诊断的T1膀胱癌的121例连续患者。所有切片均由专门的泌尿病理学家重新审查。在×200放大倍数下计数出芽灶。当出芽灶的数量为10个或更多时，肿瘤出芽被定义为阳性。使用多变量分析评估肿瘤出芽和临床结果之间的关系。中位随访时间为52个月。21例（17.4%）肿瘤出芽阳性。肿瘤出芽与T1分期、肿瘤结构和淋巴管浸润显著相关。T1期膀胱癌伴肿瘤出芽患者的5年无进展生存率为53.8%，显著低于无肿瘤出芽患者（88.4%，P = 0.001）。多变量考克斯回归分析显示，肿瘤出芽与分期进展独立相关（P = 0.002，风险比= 4.90）。在接受卡介苗滴注治疗的患者亚组（n = 88）中，肿瘤出芽也与分期进展独立相关（P = 0.003，风险比= 5.65）。肿瘤出芽可能是预测T1期膀胱癌分期进展的一个新指标，并可能易于在临床实践中引入。
Tumor budding has been defined as an isolated single cancer cell or a cluster composed of fewer than five cancer cells scattered in the stroma. It is a strong predictor for lymph node metastasis in T1 colorectal cancer. We introduced this concept to T1 non‐muscle invasive bladder cancer and evaluated whether tumor budding could have a prognostic impact on the clinical outcome. We identified 121 consecutive patients with newly diagnosed T1 bladder cancer between 1994 and 2014 at Keio University Hospital. All slides were re‐reviewed by a dedicated uropathologist. Budding foci were counted under ×200 magnification. When the number of budding foci was 10 or more, tumor budding was defined as positive. The relationship between tumor budding and clinical outcomes was assessed using a multivariate analysis. The median follow‐up was 52 months. Tumor budding was positive in 21 patients (17.4%). Tumor budding was significantly associated with T1 substaging, tumor architecture and lymphovascular invasion. The 5‐year progression‐free survival rate in T1 bladder cancer patients with tumor budding was 53.8%, which was significantly lower than that in patients without tumor budding (88.4%, P = 0.001). A multivariate Cox regression analysis revealed that tumor budding was independently associated with stage progression (P = 0.002, hazard ratio = 4.90). In a subgroup of patients treated with bacillus Calmette‐Guérin instillation (n = 88), tumor budding was also independently associated with stage progression (P = 0.003, hazard ratio = 5.65). Tumor budding may be a novel indicator for predicting stage progression in T1 bladder cancer, and would likely be easily introduced in clinical practice.
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影响因子：
3.8
作者：
Salhia, Bodour;Trippel, Mafalda;Pfaltz, Katrin;Cihoric, Nikola;Grogg, Andre;Laedrach, Claudia;Zlobec, Inti;Tapia, Coya
通讯作者：
Tapia, Coya
影响因子：
--
作者：
Zlobec I;Lugli A
通讯作者：
Lugli A
影响因子：
3.9
作者：
HASE, K;SHATNEY, C;VIERRA, M
通讯作者：
VIERRA, M
影响因子：
23.4
作者：
Denzinger, Stefan;Fritsche, Hans-Martin;Burger, Maximilian
通讯作者：
Burger, Maximilian
影响因子：
23.4
作者：
Palou, Joan;Sylvester, Richard J.;Villavicencio, Humberto
通讯作者：
Villavicencio, Humberto