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Tumor Budding: The Name is EMT. Partial EMT.

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Tumor budding, a histological feature in cancer, is linked to poor outcomes but requires standardized definitions for clinical use. This review explores its heterogeneity, clinical significance, and connection to the hybrid epithelial/mesenchymal phenotype.

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Area of Science:

  • Oncology
  • Pathology
  • Cancer Biology

Background:

  • Tumor budding is a histological feature characterized by single cells or small clusters of malignant cells in the tumor stroma.
  • It is hypothesized to reflect epithelial-mesenchymal transition and is associated with adverse cancer prognoses.
  • Significant heterogeneity exists in its definition, assessment methods, and patient stratification, hindering its routine clinical application.

Purpose of the Study:

  • To discuss the heterogeneity in defining and assessing tumor budding.
  • To review its clinical significance across various cancer types.
  • To explore its potential implementation in clinical practice and its biological underpinnings.

Main Methods:

  • Literature review of studies on tumor budding definition, assessment, and clinical significance.
  • Analysis of emerging evidence on the epithelial-mesenchymal phenotype of tumor buds.
  • Synthesis of recent findings on hybrid epithelial/mesenchymal phenotypes and collective cell migration.

Main Results:

  • Tumor budding exhibits considerable heterogeneity in its definition and assessment methodologies.
  • Evidence suggests a connection between tumor budding, partial epithelial-mesenchymal transition, and tumor cell states (proliferation, quiescence, stemness).
  • Many tumor buds display a hybrid epithelial/mesenchymal phenotype, indicative of collective cell migration.

Conclusions:

  • Standardization of tumor budding definition and assessment is crucial for its reliable use as a prognostic marker.
  • Tumor budding represents a hybrid epithelial/mesenchymal phenotype associated with collective cell migration and potentially poor outcomes.
  • Further research is needed to integrate tumor budding into routine clinical practice for cancer patient management.