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Tumor Budding Assessment with Cytokeratin and Its Significance in Laryngeal Squamous Cell Carcinomas

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

There is a need for novel prognostic parameters in assessing laryngeal squamous cell carcinoma (LSCC). Tumor budding is an instrumental parameter, which has hardly been studied before in this organ. This study aimed to assess tumor budding in LSCCs with routine hematoxylin and eosin (H&E) stain as well as cytokeratin (CK) immunohistochemistry (IHC). Objectives were to compare the effectiveness of both these methods to assess tumor budding, to investigate the association of tumor budding and clinicopathologic features, and to determine the prognostic significance of tumor budding in LSCCs. Fifty laryngectomy specimens were included. Tumor budding was counted (20x) on slides stained with IHC–CK, and highest count per slide was noted. The cases were classified as positive (> 1 buds) or negative (no buds present). The budding index was categorized as low (< 5 buds) or high (> 5 buds). Tumor budding on H&E was absent, low and high grade in 28%, 30% and 42% cases respectively, when compared to CK-IHC in 17%, 24% and 59% of cases, respectively. Presence of lymphoplasmacytic infiltration significantly correlated with tumor budding and higher grade. Transglottic location of tumor and pT stage was associated with high budding. Presence of lymphoplasmacytic infiltrate significantly correlated with worse prognosis. Tumor budding, an easily assessable, inexpensive histopathologic parameter has seldom been studied in LSCCs. Presence of lymphoplasmacytic infiltrate in routine preoperative biopsy reporting could be useful in prognostication. CK-IHC is helpful to detect especially cases with low-grade tumor budding.

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Funding

This study was funded by the Indian Council of Medical Research (STS 2018–00552).

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Authors and Affiliations

  1. Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India

    Shreyanshi Gupta

  2. Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India

    Saraswathy Sreeram, Amanda Christina Pinto, Pooja Kundapur Suresh & Sridevi Hanaganahalli Basavaiah

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  1. Shreyanshi Gupta
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  2. Saraswathy Sreeram
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  3. Amanda Christina Pinto
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  4. Pooja Kundapur Suresh
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  5. Sridevi Hanaganahalli Basavaiah
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SG, and SS. The first draft of the manuscript was written by SG, and SS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Conceptualization: SS; Methodology: SG and SS, Formal analysis and investigation: SG and SS; Writing—original draft preparation: SG and SS; Writing—review and editing: ACP, PKS, SHB; Funding acquisition: SG guided by SS; Supervision: SS.

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Correspondence to Saraswathy Sreeram.

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The authors have no relevant financial or non-financial interests to disclose.

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Not applicable, performed on de-identified tissue blocks.

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Approval was obtained from the Institutional Ethics Committee of Kasturba Medical College, Mangalore (IEC KMC MLR 04-18/60).

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Gupta, S., Sreeram, S., Pinto, A.C. et al. Tumor Budding Assessment with Cytokeratin and Its Significance in Laryngeal Squamous Cell Carcinomas. Indian J Otolaryngol Head Neck Surg 74, 494–500 (2022). https://doi.org/10.1007/s12070-021-02981-3

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  • DOI: https://doi.org/10.1007/s12070-021-02981-3

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