Mesanenin Ürotelyal Karsinomlarında Tümör Tomurcuklanmasının Prognostik Önemi: İki Farklı Tümör Tomurcuklanma Değerlendirme Yönteminin Karşılaştırılması

Yıl 2022, Cilt: 4 Sayı: 3, 293 - 296, 22.09.2022

İrfan Öcal , İsmail Güzeliş

https://doi.org/10.37990/medr.1092250

Öz

Giriş: Çalışmamızda ürotelyal karsinomlarda tümör tomurcuklanmasının (TT) prognoza etkisini ortaya koymayı ve en sık kullanılan alternatif metod (AM) ile Uluslararası Tümör Tomurcuklanması Konsensus Konferans (ITBCC) sistemini karşılaştırmayı amaçladık.TT, rutin Hematoksilen&Eozin boyalı preparatlarda kolayca değerlendirilebilmektedir. Yapılan çalışmalarda TT’nin birçok organ kanserinde prognostik parametrelerle ilişkili olduğu bulunmuştur. TT değerlendirmesi, birçok organ kanserinde ITBCC’ye veya alternatif olarak farklı yazarlar tarafından kullanılan farklı değerlere dayanmaktadır.
Materyal ve Methot: Çalışmaya 2010’dan 2016’ya kadar, sistektomi veya sistoprostatektomi ile cerrahi evreleme yapılan ve en az 5 yıl takip edilen vakalardan oluşan kırk sekiz ürotelyal kanser dahil edildi. Tüm hematoksilen ve eozin boyalı preparatlar, ITBCC ve AM’ye göre TT durumu açısından yeniden değerlendirildi.
Bulgular: ITBCC’ye göre TT, pT, lenfovasküler invazyon, lenf nodu tutulumu(LNT), tümör evresi ve 5 yıllık mortalite ile korele değildi (p=0.102, p=0.722, p = 0.165, p=0.431, p=0.524). AM’ye göre, TT, pT ilerledikçe daha sıktı ve LNT ile marjinal olarak ilişkiliydi (p=0.027, p=0.058). TT ile genel sağkalım arasında ilişki yoktu (p=0.130).
Sonuç: Çalışmamızda AM’deki eşik değeri ITBCC önerisinden daha faydalı bulduk. TT’nin bazı prognostik parametrelerle ilişkisi prognozla da ilişkili olabileceğini düşündürse de, genel sağkalım ile bir ilişki bulunamadı. Bu durum vaka sayımızla ilgili olabilir.

Prognostic Significance of Tumor Budding in Urothelial Carcinomas of the Bladder: Comparison of Two Different Tumor Budding Evaluation Methods

Öz

Aim: In our study, we aimed to reveal the effect of tumor budding(TB) on prognosis in urothelial carcinomas and to compare the most commonly used alternative method (AM) and the International Tumor Budding Consensus Conference (ITBCC) system. TB can be easily assessed on routine hematoxylin and eosin-stained slides. In studies, TB was found to be associated with prognostic parameters in many organs. TB assessment in many organ cancers is based on ITBCC or alternatively different values used by different authors.
Material and Method: Forty-eight urothelial cancers were obtained from 2010 to 2016 that was comprised of those having undergone surgical staging with a cystectomy or cystoprostatectomy and at least 5 years followed up. All hematoxylin and eosin-stained slides were re-evaluated for the status of TB according to ITBCC and AM.
Results: According to ITBCC TB was not correlated with pT, lymphovascular invasion, lymph node involvement (LNI), tumor stage and 5-year mortality (p=0.102, p=0.722, p=0.165, p=0.431, p=0.524). According to AM, TB was more frequent as pT advanced, and was marginally associated with LNI (p=0.027, p=0.058). There was no relationship between TB and overall survival (p=0.130).
Conclusion: We found the cut-off value in AM more useful than ITBCC recommendations. Although the association of TB with some of the prognostic parameters suggests that it may also be associated with prognosis, no relationship was found with overall survival. This may be related to the number of our cases.

Anahtar Kelimeler

Tumor budding, Urothelial carcinoma, Bladder cancer

Kaynakça

• 1)Sung, H., Ferlay, J., Siegel, RL, Laversanne, M, Soerjomataram, I, Jemal, A, Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021: 71: 209- 249. https://doi.org/10.3322/caac.21660
• 2) Moch H., Humphrey P.A., Ulbright T.M., Reuter V. WHO Classification of Tumours of the Urinary System and Male Genital Organs. International Agency for Research on Cancer, Lyon, France 2016
• 3) Lugli, A., Kirsch, R., Ajioka, Y. et al. Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016. Mod Pathol 30, 1299–1311 (2017). https://doi.org/10.1038/modpathol.2017.46
• 4)Choi HJ, Park KJ, Shin JS, Roh MS, Kwon HC, Lee HS. Tumor budding as a prognostic marker in stage-III rectal carcinoma. Int J Colorectal Dis. 2007; 863-8. doi: 10.1007/s00384-006-0249-8.
• 5)Kanazawa H, Mitomi H, Nishiyama Y, Kishimoto I, Fukui N, Nakamura T, Watanabe M. Tumour budding at invasive margins and outcome in colorectal cancer. Colorectal Dis. 2008: 41-7. doi: 10.1111/j.1463-1318.2007.01240.x.
• 6)Roh MS, Lee JI, Choi PJ. Tumor budding as a useful prognostic marker in esophageal squamous cell carcinoma. Dis Esophagus. 2004;17:333-7. doi: 10.1111/j.1442-2050.2004.00436.x.
• 7)Sarioglu S, Acara C, Akman FC, Dag N, Ecevit C, Ikiz AO, Cetinayak OH, Ada E; for Dokuz Eylül Head and Neck Tumour Group (DEHNTG). Tumor budding as a prognostic marker in laryngeal carcinoma. Pathol Res Pract. 2010 15;206:88-92. doi: 10.1016/j.prp.2009.09.006.
• 8)Koyuncuoglu M, Okyay E, Saatli B, Olgan S, Akin M, Saygili U. Tumor budding and E-Cadherin expression in endometrial carcinoma: are they prognostic factors in endometrial cancer?.Gynecol Oncol. 2012;125(1):208-13. doi:10.1016/j.ygyno.2011.12.433.
• 9)Park JY, Hong DG, Chong GO, Park JY. Tumor Budding is a Valuable Diagnostic Parameter in Prediction of Disease Progression of Endometrial Endometrioid Carcinoma. Pathol Oncol Res. 2019;723-30. doi:10.1007/s12253-018-0554-x.
• 10)Küçük Ü, Ekmekçi S, Çakır E, Ekin Z, Ergani B, Ekin GR. Prognostic significance of tumor budding in muscle invasive urothelial carcinomas of the bladder. Turk J Urol. 2018;45(4):273-278. Published 2018 Aug 31. doi:10.5152/tud.2018.58269
• 11)Brieu N, Gavriel CG, Nearchou IP, Harrison DJ, Schmidt G, Caie PD. Automated tumour budding quantification by machine learning augments TNM staging in muscle-invasive bladder cancer prognosis. Sci Rep. 2019;9(1):5174. Published 2019 Mar 26. doi:10.1038/s41598-019-41595-2
• 12)Seker NS, Tekin E, Özen A, Can C, Colak E, Acikalin MF. Prognostic significance of tumor budding in muscle invasive urothelial carcinomas of the urinary bladder. Ann Diagn Pathol. 2021;54:151786. doi:10.1016/j.anndiagpath.2021.151786
• 13)Raventós Busquets C, X, Semidey M, E, Lozano Palacio F, Carrión Puig A, Aula Olivar A, De Torres Ramírez I, M, Trilla Herrera E: Is Tumor Budding a New Predictor for Early Cystectomy in pT1 High-Grade Bladder Cancer? Urol Int 2021. doi: 10.1159/000517543
• 14)Fukumoto K, Kikuchi E, Mikami S, et al. Tumor budding, a novel prognostic indicator for predicting stage progression in T1 bladder cancers. Cancer Sci. 2016;107(9):1338-1344. doi:10.1111/cas.12990
• 15)Lorenzo Soriano L, Ordaz Jurado G, Pontones Moreno JL, et al. Tumor Budding: Prognostic Value in Muscle-invasive Bladder Cancer. Urology. 2019;130:93-98. doi:10.1016/j.urology.2019.04.006