The relationship between tumor budding and clinicopathological parameters in patients with gastric adenocarcinoma

Background: Gastric cancer is the third most common cause of cancer-related death worldwide. Tumor budding is an easy to detect histopathological feature associated with a poor prognosis in patients with several types of cancer. The present study aimed to determine the relationship between tumor budding and clinicopathological parameters in gastric adenocarcinoma patients. Materials and Methods: This study retrospectively analyzed the H and E-stained slides of 146 patients that were diagnosed with gastric adenocarcinoma between 2013 and 2017. Tumor budding, large cell invasion, mitosis, fibrosis, and peritumoral lymphocytic response were recorded in all cases. The relationship between tumor budding and clinicopathological prognostic parameters was statistically analyzed. Results: Increased tumor budding density (≥10 tumor buds) was observed in 62 (42.5%) of the patients. There was a significant relationship between increased tumor budding density and histological grade (P < 0.001), lymphovascular invasion (P = 0.016), perineural invasion (P < 0.001), lymph node involvement (P = 0.015), and tumor invasion depth (pT stage) (P < 0.001). There was also a significant relationship between a high fibrosis rate, and lymphovascular invasion (P < 0.001), lymph node involvement (P = 0.030), and pT stage (P = 0.002); however, there wasn't a significant association between prognostic parameters, and large cell invasion, the mitotic count, and peritumoral lymphocytic response. Conclusions: The present findings suggest that increased tumor budding density in gastric adenocarcinoma patients may be used to predict poor prognosis.