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Published on: May 1, 2019
Analysis of histological parameters of aggressiveness in resected lung squamous cell carcinoma
Giorgia Andrea Impalà1, Alessandra Pittaro2, Francesco Guerrera3,4
1Department of Medical Sciences, City of Health and Sciences hospital, University of Turin, Turin, Italy.
Introduction:
Lung squamous cell carcinoma (LUSCC) lacks consistent morphological criteria for tumour grading. Tumour budding (TB), defined as isolated cells or clusters of fewer than 4 cells at the invasive front, is prognostic in several carcinomas but remains insufficiently validated in LUSCC.
Objective:
To assess histopathological features of aggressiveness (including TB) in resected LUSCC as prognostic parameters and grading factors.
Methods:
We retrospectively analysed 296 LUSCC cases (2010-2021, University of Turin). Clinical data were collected and slides were reviewed for subtype, nuclear features, mitotic count, infiltration pattern, TB, spread through air spaces (STAS), desmoplasia, pleural/vascular/perineural invasion, and tumour-infiltrating lymphocytes. Associations with recurrence-free and overall survival were tested.
Results:
High TB (≥ 5 buds) correlated with pleural invasion and advanced T stage and was significantly associated with shorter recurrence-free (HR 1.84, p = 0.008) and overall survival (HR 1.73, p = 0.003), independently of stage. Nuclear enlargement and necrosis also predicted worse outcomes, while surgery had an overall protective impact.
Conclusion:
TB, necrosis, and nuclear size are independent predictors of outcome in LUSCC. Their inclusion in pathology reports may improve grading, refine prognosis, and guide management.
