Clinicopathological Relevance of Tumor Budding at the Invasive Tumor Front in Early-Stage Oral Tongue Squamous Cell Carcinoma: Histological and Immunohistochemical Analysis

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Alonso, S. E., Serrano, F. A., Cuéllar, I. N., López, A. L., Acosta, D. F., Moure, B. G., León, J. Z., & Cuéllar, C. N. (2026). Clinicopathological Relevance of Tumor Budding at the Invasive Tumor Front in Early-Stage Oral Tongue Squamous Cell Carcinoma: Histological and Immunohistochemical Analysis. Head & neck, 48(2), 325–338. https://doi.org/10.1002/hed.28204

Abstract

Background Tumor budding (TB) is characterized by isolated tumor cells or cell clusters at the invasive tumor front in squamous cell carcinoma (SCC) of the tongue. Methods This research (n = 61) aimed to analyze the diagnostic methodology of TB, the association between the tumoral features and TB, the immunohistochemical characteristics and their correlation with the TB index (TBI), assess the prognostic factors of TB in relation to cervical metastases and analyze disease-free survival (DFS) and overall survival (OS). Results A statistically significant association was found between TB and depth of invasion (DOI), perineural invasion, E-Cadherin expression, and Ki-67 index. Regarding cervical metastases, a statistically significant association was observed with DOI, perineural invasion, TBI, E-Cadherin expression, and Ki-67 index. Conclusions TB correlates significantly with DOI and perineural invasion. Patients with a high TBI are associated with decreased E-cadherin expression and an increased Ki-67 index. TBI is an independent prognostic factor for the presence of cervical lymphatic metastases, and no association was found between the TBI and DFS or OS.

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