Abstract

INTRODUCTION

For lung squamous cell carcinoma (SCC), there is no histological parameter that have been universally accepted as a prognostic factor. However in recent years, tumor budding (TB) has been recognized as a prognostic factor. In this study, we investigated the ratio of TB in lung SCC and its influence on prognosis.

METHODS

Our study consisted of 36 resected lung SCC, diagnosed at the Baskent University, Department of Pathology, between 2011 and 2016. All haematoxylin and eosin-stained slides were reviewed. TB was defined as small tumor nests composed of less than 5 tumour cells that are branching from big tumor islands to the adjacent paranchyma. They were counted in 1 high-power fields (HPF) in hot spot areas.

RESULTS

In histomorphological evaluation, TB was observed in all patients with the mean number of 5,36±3,27 in 1 HPF. TB was <5/1HPF in 13 cases (36.1%) and ≥5/1 HPF in 23 cases (63.9%). The significant correlation was detected between TB and pT stage (p=0.005), lymph node metastasis (p=0,032), metastasis (p=0,05) and TNM stage (p=0,003). Patients with <5 budding/1 HPF had a mean overall survival of 49±14,6 months, compared with 30,1±17,7 months for those patients whose tumors had ≥5 budding (p=0,006).

DISCUSSION AND CONCLUSION

In conclusion, the significant association was detected between TB and pT stage, TNM stage, lymph node metastasis/metastasis and overall survival. Hence, this study demonstrated that TB is an important predictor of poor prognosis in patients with SCC and it can be used as an histologic parameter in grading of lung SCC.