Cytokeratin-Based Assessment of Tumour Budding in Colorectal Cancer

Introduction: 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 tumour, node, metastasis (TNM) stage, many tumours behave poorly. The independent forecasting tool for 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. The aim of this study was to evaluate TB using pan-cytokeratin immunostain and comparing it with haematoxylin and 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: Among the various clinicopathological parameters evaluated in 83 cases of CRC, we emphasise from our study that there was a strong correlation of TB score with tumour type, grade of tumour and metastasis. 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 TB is superior compared with the TB score assessed by H&E alone.