Cytokeratin Based Assessment of Tumour Budding in Colorectal Cancer

Abstract Background: One of the most prevalent and major causes of cancer-related mortality is colorectal cancer(CRC). Unfortunately, despite being labelled as low-risk cancers based on their TNM stage, many tumours behave poorly. Therefore, a key area of research has been the search for additional prognostic factors in the evaluation of CRC. The independent forecasting tool for colorectal cancer(CRC), particularly in node-negative illness, is tumour budding(TB). The term "tumour buds"(TB) refers to detached (epithelial) tumour cells, which are single or clusters (less than or equal to five cells) at the maximum invasive front. This prospective study was carried out by evaluating tumour buds using pan-cytokeratin immunostain and comparing it with Haematoxylin & Eosin(H&E) staining and clinicopathological parameters. Methods: Resected specimens without presurgical therapy were analysed in the Department of Pathology for one year. Among histologically proven colorectal carcinoma, TB scores on H & E and pan-cytokeratin immunostained slides were compared. Results: Of the clinicopathological parameters evaluated in 83 cases of colorectal cancer, there was a strong correlation of tumour budding score with tumour type ('p' value <0.004), grade of the tumour ('p' value <0.001), and metastasis ('p' value <0.001) and were statistically significant. There is a definitive chance of upgradation of TB score by cytokeratin immunostain Conclusion: TB is a negative prognostic factor responsible for adverse outcomes in CRC patients. Regardless of the scoring method used, cytokeratin-based assessment of tumour budding is superior compared with the TB score assessed by H&E alone.