NGHIÊN CỨU ĐẶC ĐIỂM CỦA NẢY CHỒI U TRONG UNG THƯ BIỂU MÔ TUYẾN ĐẠI TRỰC TRÀNG

Abstract

Introduction: Colorectal cancer is the most common malignant disease of the gastrointestinal tract with a high mortality rate. Tumor budding is an important prognostic factor associated with lymph node metastasis, distant metastasis, local recurrence, and reduced overall survival and disease-free survival. Objectives: To assess the tumor budding and its relation with several histopathological features. Material and Methods: A retrospective cross-sectional descriptive study was conducted on hematoxylin and eosin (H&E)-stained slides of 103 patients with primary colorectal adenocarcinoma who underwent tumor resection and regional lymph node dissection without preoperative chemoradiotherapy, from January 2017 to November 2018 at Hanoi Medical University Hospital. Data analysis was performed using SPSS version 20.0. A p-value of <0.05 was considered statistically significant. The study complied with the Declaration of Helsinki on ethical principles for medical research involving human subjects and was approved by the Biomedical Ethics Committee of Hanoi Medical University (IRB-VN922). Results: The mean age of patients was 62.96 ± 12.651 years, with the most common age group being 60–69 years (36.9%). Males accounted for a higher proportion than females (55.3% vs. 44.7%). The most common anatomical site was the rectum (32.0%). Most cases were of the conventional type of adenocarcinoma (82.5%), moderately differentiated (86.4%), and at pathological stage pT3 (53.4%). The overall lymph node metastasis rate was 41.7%, with metastasis to 1–3 lymph nodes being the most common (32.0%). Tumors at stages I, II, and III accounted for 5.8%, 52.4%, and 41.7% of cases, respectively. The rates of lymphovascular and perineural invasion were 38.8% and 36.9%, respectively. Tumor budding was classified into three levels: low (Bd1, 52.4%), intermediate (Bd2, 28.2%), and high (Bd3, 19.4%). High-grade tumor budding was more frequently observed in patients with lymph node metastasis, deeper invasion stage, lymphovascular invasion, and perineural invasion (p < 0.05). Conclusion: High-grade tumor budding is a poor prognostic factor in colorectal carcinoma.