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Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016
发布日期：2018/2/7 23:01:58 文章来源： 作者: 点击次数：4587
Modern Pathology (2017) 30, 1299–1311
Recommendations for reporting tumor budding
in colorectal cancer based on the International
Tumor Budding Consensus Conference
Lugli A1, Kirsch R2, Ajioka Y3, Bosman F4, Cathomas G5, Dawson H1, El Zimaity H6, Fléjou JF7, Hansen TP8, Hartmann A9, Kakar S10, Langner C11, Nagtegaal I12, Puppa G13, Riddell R2, Ristimäki A14, Sheahan K15, Smyrk T16, Sugihara K17, Terris B18, Ueno H19, Vieth M20, Zlobec I1, Quirke P21.
Abstract: Tumor budding is a well-established independent prognostic factor in colorectal cancer but a standardized method for its assessment has been lacking. The primary aim of the International Tumor Budding Consensus Conference (ITBCC) was to reach agreement on an international, evidence-based standardized scoring system for tumor budding in colorectal cancer. The ITBCC included nine sessions with presentations, a pre-meeting survey and an e-book covering the key publications on tumor budding in colorectal cancer. The ‘Grading of Recommendation Assessment, Development and Evaluation’ method was used to determine the strength of recommendations and quality of evidence. The following 10 statements achieved consensus: tumor budding is defined as a single tumor cell or a cell cluster consisting of four tumor cells or less (22/22, 100%). Tumor budding is an independent predictor of lymph node metastases in pT1 colorectal cancer (23/23, 100%). Tumor budding is an independent predictor of survival in stage II colorectal cancer (23/23, 100%). Tumor budding should be taken into account along with other clinicopathological features in a multidisciplinary setting (23/23, 100%). Tumor budding is counted on H&E (19/22, 86%). Intratumoral budding exists in colorectal cancer and has been shown to be related to lymph node metastasis (22/22, 100%). Tumor budding is assessed in one hotspot (in a field measuring 0.785 mm 2 ) at the invasive front (22/22, 100%). A three-tier system should be used along with the budding count in order to facilitate risk stratification in colorectal cancer (23/23, 100%). Tumor budding and tumor grade are not the same (23/23, 100%). Tumor budding should be included in guidelines/protocols fo colorectal cancer reporting (23/23, 100%). Members of the ITBCC were able to reach strong consensus on a single international, evidence-based method for tumor budding assessment and reporting. It is proposed that this method be incorporated into colorectal cancer guidelines/protocols and staging systems.
摘要：肿瘤出芽是结直肠癌的独立预后因素，但缺乏评估的标准化方法。国际肿瘤共识会议（ITBCC）的主要目的是就国际上以证据为基础的结直肠癌肿瘤出芽标准化评分系统达成协议。 ITBCC包括九个会议，演讲，会前调查和电子书，涵盖关于大肠癌肿瘤出芽的主要出版物。推荐评估，开发和评估评估方法被用于确定建议的实力和证据质量。以下10个报告达成共识：肿瘤出芽定义为单个肿瘤细胞或由四个肿瘤细胞组成的细胞簇（22/22,100％）。肿瘤出芽是pT1结直肠癌淋巴结转移的独立预测因子（23/23,100％）。肿瘤发芽是II期结直肠癌存活的独立预测因子（23/23,100％）。在多学科环境中应考虑肿瘤的出芽以及其他临床病理特征（23/23,100％）。H＆E（19/22，86％）计算肿瘤出芽。肿瘤内出现存在于结肠直肠癌，已显示与淋巴结转移有关（22/22,100％）。在侵入性前端（22/22,100％）的一个热点（在0.785mm 2的场中）进行肿瘤发芽评估。应该使用三层体系和萌芽计数，以促进结肠直肠癌的风险分层（23/23,100％）。肿瘤发芽和肿瘤分级不一样（23/23,100％）。肿瘤出芽应纳入结肠直肠癌报告指南/方案（23/23,100％）。 ITBCC能够就肿瘤出芽评估和报告的单一国际，循证方法达成强有力的共识。建议将该方法纳入结肠直肠癌指南/方案和分期系统。（翻译 徐梦微）