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Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications

SIMPLE SUMMARY: To obtain the optimal treatment effect of endoscopic resection (ER) in early gastric carcinoma (EGC), a well-established indication for post-ER surgery is needed. In addition, accurate prediction of lymph node metastasis (LNM) is necessary to achieve this goal. Here, we present modif...

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Autores principales: Yim, Kwangil, Jang, Won Mo, Lee, Sung Hak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306932/
https://www.ncbi.nlm.nih.gov/pubmed/34298621
http://dx.doi.org/10.3390/cancers13143405
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author Yim, Kwangil
Jang, Won Mo
Lee, Sung Hak
author_facet Yim, Kwangil
Jang, Won Mo
Lee, Sung Hak
author_sort Yim, Kwangil
collection PubMed
description SIMPLE SUMMARY: To obtain the optimal treatment effect of endoscopic resection (ER) in early gastric carcinoma (EGC), a well-established indication for post-ER surgery is needed. In addition, accurate prediction of lymph node metastasis (LNM) is necessary to achieve this goal. Here, we present modified tumor budding (mTB), which excludes signet ring cells from conventional tumor budding (TB) as a novel predictor for LNM. Conventional TB and mTB were the most predictive independent factors for LNM. Furthermore, mTB was superior to TB in predicting LNM (p = 0.0004–0.0008). In conclusion, mTB significantly enhanced the predictive power of LNM, which could be a novel indicator for determining post-ER surgery. ABSTRACT: Endoscopic resection (ER) is a minimally invasive treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis (LNM). Recently, tumor budding (TB) has emerged as a potential predictor of LNM in EGC. We assessed the clinical significance of modified TB (mTB) that excludes the signet ring cell component and compared several TB assessment methods. Two hundred and eighty-nine patients with EGC at Uijeongbu St. Mary’s Hospital from 2010 to 2021 were enrolled. In univariate analysis, age, size, depth of invasion, tumor type, histologic type, Lauren classification, lymphatic invasion, venous invasion, poorly differentiated carcinoma (“not otherwise specified” predominant), and TB were significantly associated with LNM. Multivariate regression analysis showed that mTB (difference area under the curve [dAUC] = 0.085 and 0.087) was superior to TB (dAUC = 0.054 and 0.057) in predicting LNM. In addition, total TB counts on representative slide sections (dAUC = 0.087 and 0.057) in assessing TB and mTB and the ITBCC method (dAUC = 0.085) in mTB were superior to the presence or absence method (dAUC = 0.042 and 0.029). The mTB significantly increases LNM prediction ability, which can provide important information for patients with EGC.
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spelling pubmed-83069322021-07-25 Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications Yim, Kwangil Jang, Won Mo Lee, Sung Hak Cancers (Basel) Article SIMPLE SUMMARY: To obtain the optimal treatment effect of endoscopic resection (ER) in early gastric carcinoma (EGC), a well-established indication for post-ER surgery is needed. In addition, accurate prediction of lymph node metastasis (LNM) is necessary to achieve this goal. Here, we present modified tumor budding (mTB), which excludes signet ring cells from conventional tumor budding (TB) as a novel predictor for LNM. Conventional TB and mTB were the most predictive independent factors for LNM. Furthermore, mTB was superior to TB in predicting LNM (p = 0.0004–0.0008). In conclusion, mTB significantly enhanced the predictive power of LNM, which could be a novel indicator for determining post-ER surgery. ABSTRACT: Endoscopic resection (ER) is a minimally invasive treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis (LNM). Recently, tumor budding (TB) has emerged as a potential predictor of LNM in EGC. We assessed the clinical significance of modified TB (mTB) that excludes the signet ring cell component and compared several TB assessment methods. Two hundred and eighty-nine patients with EGC at Uijeongbu St. Mary’s Hospital from 2010 to 2021 were enrolled. In univariate analysis, age, size, depth of invasion, tumor type, histologic type, Lauren classification, lymphatic invasion, venous invasion, poorly differentiated carcinoma (“not otherwise specified” predominant), and TB were significantly associated with LNM. Multivariate regression analysis showed that mTB (difference area under the curve [dAUC] = 0.085 and 0.087) was superior to TB (dAUC = 0.054 and 0.057) in predicting LNM. In addition, total TB counts on representative slide sections (dAUC = 0.087 and 0.057) in assessing TB and mTB and the ITBCC method (dAUC = 0.085) in mTB were superior to the presence or absence method (dAUC = 0.042 and 0.029). The mTB significantly increases LNM prediction ability, which can provide important information for patients with EGC. MDPI 2021-07-07 /pmc/articles/PMC8306932/ /pubmed/34298621 http://dx.doi.org/10.3390/cancers13143405 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yim, Kwangil
Jang, Won Mo
Lee, Sung Hak
Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title_full Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title_fullStr Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title_full_unstemmed Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title_short Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications
title_sort modified tumor budding as a better predictor of lymph node metastasis in early gastric cancer: possible real-world applications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306932/
https://www.ncbi.nlm.nih.gov/pubmed/34298621
http://dx.doi.org/10.3390/cancers13143405
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