The clinical significance of tumor budding in predicting lymph node metastasis of T1 colorectal cancer

章琼燕; 赵胜男; 王　磊

doi:10.3969/j.issn.1007-3969.2015.11.005

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The clinical significance of tumor budding in predicting lymph node metastasis of T1 colorectal cancer

更新时间：2025-12-31

- The clinical significance of tumor budding in predicting lymph node metastasis of T1 colorectal cancer
- China Oncology Vol. 25, Issue 11, Pages: 865-870(2015)
- 作者机构：
  
  复旦大学附属肿瘤医院病理科，复旦大学上海医学院肿瘤学系,上海,20032
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2015.11.005
  CLC：
- Published Online：01 February 2016，
  
  Published：01 February 2015
- 稿件说明：
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章琼燕,赵胜男,王　磊,等. 肿瘤出芽计数在预测T1期结直肠癌淋巴结转移中的应用价值[J]. 中国癌症杂志, 2015, 25(11): 865-870.

章琼燕, 赵胜男, 王　磊. The clinical significance of tumor budding in predicting lymph node metastasis of T1 colorectal cancer[J]. China Oncology, 2015, 25(11): 865-870.
章琼燕,赵胜男,王　磊,等. 肿瘤出芽计数在预测T1期结直肠癌淋巴结转移中的应用价值[J]. 中国癌症杂志, 2015, 25(11): 865-870. DOI： 10.3969/j.issn.1007-3969.2015.11.005.

章琼燕, 赵胜男, 王　磊. The clinical significance of tumor budding in predicting lymph node metastasis of T1 colorectal cancer[J]. China Oncology, 2015, 25(11): 865-870. DOI： 10.3969/j.issn.1007-3969.2015.11.005.

摘要

背景与目的：肿瘤出芽是结直肠癌的不良预后因素。本研究使用10个高倍镜视野计数的方法评价肿瘤出芽，并分析其在预测T1期结直肠癌淋巴结转移中的临床应用价值。方法：通过计数307例T1期结直肠癌10个高倍镜视野下肿瘤出芽个数，参比临床病理特征，建立T

期结直肠癌淋巴结转移的风险分析公式，并在14例新病例中对该公式进行验证。结果：多因素分析结果显示，肿瘤分化水平、脉管侵犯和肿瘤出芽个数与T

期结直肠癌淋巴结转移显著相关。统计分析得出的淋巴结转移的风险分析公式为：Z=1.571×(脉管状态：侵犯为1；无侵犯为0)+2.661×(肿瘤分化：高级别为1；低级别为0)+0.024×(肿瘤出芽个数)-3.885，概率=1/1+e

-Z

。在14例新病例中得到了验证。结论：通过计数10个高倍镜视野下的肿瘤出芽个数，可以精确地评估淋巴结转移风险，从而协助临床作出合理的决策。

Abstract

Background and purpose: Tumor budding is a poor prognostic factor in colorectal cancer. In this study

we studied the tumor budding by counting the actual number in 10 high power fields and evaluated its clinical application in predicting lymph node metastasis of T

colorectal cancer. Methods: Tissue specimens from 307 patients with histologically confirmed T1 colorectal cancer were enrolled. The clinicopathological characteristics including tumor budding were evaluated for their predictive value in lymph node metastasis. A formula was created to calculate the risk score for prediction of lymph node metastasis which was validated by 14 new cases. Results: In the multivariate analysis

it showed that tumor grade

lymphovascular invasion and the number of tumor budding were

significantly associated with lymph node metastasis. The probability of lymph node metastasis was calculated using the following equations: Z=1.571×(lymphovascular state: invasion

1; no invasion

0)+2.661×(tumor grade: high grade

1; low grade

0)+0.024×(budding counts)−3.885; Probability=1/1+e

−Z

. The high scores were correlated with the lymph node metastasis in the validations. Conclusion: We can accurately assess the risk of lymph node metastasis by counting the number of tumor budding in 10 high power fields. Therefore tumor budding could potentially assist treatment decision making in T

colorectal cancer patients with high-risk lymph node metastasis.

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