Determination of budding grades in squamous cell carcinomas of the oropharynx

Didovets, D.Yu. and Rakhmanov, V.V. and Chekan, S.M. and Alekseenko, O.A. (2026) Determination of budding grades in squamous cell carcinomas of the oropharynx. Медичні перспективи = Medicni perspektivi (Medical perspectives), т. 31 (2). pp. 99-107. ISSN 2307-0404 (print), 2786-4804 (online)

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Abstract

The World Health Organization report on the prevalence of oropharyngeal cancer (OC) places it in sixth place among men and tenth among women worldwide. A pressing problem is the increase in OC cases in recent decades among young patients, which researchers associate infection with high-risk human papillomavirus (HPV). Among all OC, many histological forms are squamous cell carcinomas (SCC). It should be noted that HPV-associated carcinomas have a better prognosis, namely up to 20% of patients do not show recurrence after treatment, which is significantly different from the course observed in patients with HPV-unassociated OC. In the context of cancer prognosis, another important prognostic indicator is interesting - tumor budding (TB), which actively develops on the side of the invasive front of the tumor and is often described in literature as an independent factor of poor prognosis, early vascular invasion and metastasis. There are very few studies comparing the intensity of TB and HPV association for the prognosis of SCC and they mostly concern tumors of other areas of the head and neck, which determines the relevance of this work.The aim of the work is to investigate the distribution of tumor budding gradations according to clinical and morphological characteristics of oropharyngeal squamous cell carcinomas important for prognosis, in particular, to assess the relationship of budding with HPV association (p16 status) and proliferation index (Ki-67 expression).For the study, biopsy and surgical material samples of SCC of the oropharynx of 69 patients (21 women and 48 men) who were in the oncology department of the Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov, Dnipro from 2019 to 2022 and received appropriate treatment were selected. The age of the patients ranged from 45 to 86 years; the average age was 64.09±8.95 years. IHC was performed according to the TermoScientific (TS) protocols with primary antibodies p16 (sp1, RTU, LabVision, USA) and Ki-67 (sp6, RTU, LabVision, USA), and the Lab Vision Quanto (TS, USA) imaging system.The distribution of TB grades according to the three-level system (from 0 to 4 cells - 1 (low), from 5 to 9 clusters – 2 (moderate), from 10 and more – 3 (high) according to clinical and morphological indicators showed a statistically significant difference only by the sex of the patients, namely the gradation of high budding levels among men was significantly higher than among women (10 out of 11 (90.91%) compared to 1 out of 11 (9.09%)), (p<0.05), this is probably due to the prevalence of such bad habits among men as smoking and alcohol abuse, which are frequent etiological causes of head and neck cancer development, as an alternative path to the development of OC without HPV infection.Distribution of TB grades in HPV-positive samples (p16 – positive) and HPV-negative (p16-negative) OC demonstrated the largest number of HPV-negative carcinomas in the subgroup with 3 budding grades, namely with grade 1 HPV-negative (p16-negative) were 59.38% of samples (19 out of 32), with grade 2 – 57.69% of samples (15 out of 26), and with grade 3 – already 90.91% of samples (10 out of 11), (p<0.05), which confirms the more unfavorable prognosis of HPV-unassociated OC.The proliferation index by Ki-67 did not show a statistically significant relationship with the distribution of TB grades, which makes the latter an independent factor in the prognosis in SCC of the oropharynx

Item Type:	Article
Additional Information:	doi: 10.26641/2307-0404.2026.2.365607
Uncontrolled Keywords:	Key words: squamous cell carcinoma, oropharynx, budding, grading, prognosis, immunohistochemistry, Ki-67, p16; плоскоклітинний рак, ротоглотка, брунькування, градації, прогноз, імуногістохімія, Кі-67, р16
Subjects:	Oncology
Divisions:	Previous Names of Departments > Department of Pathological Anatomy and Forensic Medicine
Depositing User:	Ирина Медведева
Date Deposited:	09 Sep 2026 07:09
Last Modified:	09 Sep 2026 07:09
URI:	http://repo.dma.dp.ua/id/eprint/10272

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