Association of Tumour Budding with Lymphovascular Invasion and Histological Grade in Colorectal Adenocarcinoma: A Prospective Observational Study

Enoch Raju Kanikella; Pradeep Masa; Raparthi Srujana

doi:10.37022/wjcmpr.v8i3.453

Authors

Enoch Raju Kanikella Associate Professor, Department of Pathology, Raniganj Institute of Medical Sciences, Raniganj, West Bengal, India.
Masa Pradeep Associate Professor, Department of Pathology, Kerala Medical College, Mangode, Keralam, India.
Raparthi Srujana Assistant Professor, Department of Pathology, Government Medical College, Mahabubnagar, Telangana, India.

Abstract

Background: Tumour budding is increasingly recognized as a marker of aggressive behaviour in colorectal carcinoma. This study aimed to evaluate its association with lymphovascular invasion (LVI), histological grade, and other adverse pathological features.

Methods: This prospective observational study included 120 colorectal adenocarcinoma resection specimens. Tumour budding was assessed according to the ITBCC criteria and classified as Bd1, Bd2, or Bd3. Associations with LVI, histological grade, pT stage, nodal status, tumour deposits, and pathological stage were analysed.

Results: Bd1, Bd2, and Bd3 were identified in 46.7%, 30.0%, and 23.3% of cases, respectively. The incidence of LVI increased from 19.6% in Bd1 to 60.7% in Bd3, while the proportion of high-grade tumours increased from 7.1% to 50.0% (both p < 0.001). Higher tumour budding grades were also associated with nodal positivity, advanced pT stage, tumour deposits, and higher pathological stage. On multivariable analysis, LVI, high histological grade, and nodal positivity remained independently associated with intermediate-to-high tumour budding.

Conclusion: Tumour budding closely reflects adverse pathological features in colorectal adenocarcinoma and may serve as a valuable histopathological marker of aggressive tumour behaviour.

Keywords:

Colorectal adenocarcinoma, Tumour budding, Lymphovascular invasion, Histological grade, Nodal metastasis

DOI

https://doi.org/10.37022/wjcmpr.v8i3.453

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