The Relationship Between Tumor Budding and Clinical Pathological
Characteristics of Cervical Cancer and Its Prognostic Significance:A
Meta Analysis
Abstract
Objective: To explore the relationship between tumor budding and
clinical pathological characteristics and prognosis of cervical cancer;
Methods: By searching Pubmed, Embase, Cochren, CNKI and CBM databases,
the research studies on the relationship between tumor budding and
prognosis or clinic-pathological characteristics of cervical cancer were
included. The quality of researches included was evaluated according the
Castle Ottawa Scale (NOS) and statistically analyzed by Stata 12.0.
Result: A total of 10 studies were included, including 11 cohorts.
Including 2017 patients, the NOS score of these studies is more than 6
points. Tumor budding is related to age and tumor size of cervical
cancer. In part of pathological characteristics, squamous cell
carcinoma, higher stage, lymph node metastasis, distant metastasis, high
WHO grade, deep interstitial invasion, Lymphatic vessel vascular space
invasion, nerve invasion and para uterine invasion are more likely to
occur tumor budding, occurrence of tumor sprouting in C-type cervical
adenocarcinoma is higher than that in A/B type; In univariate analysis,
there was a significant correlation between cervical cancer tumor
sprouting and disease-free survival in patients (RR=6.511,P=0.000), in
multivariate analysis, there was also a significant correlation between
those (HR=3.358,P=0.001); Subgroup analysis of univariate analysis
showed that Asian (RR=1.879, P=0.000), sample size ≤ 300 (RR=1.875,
P=0.000), inclusion of squamous cell carcinoma (RR=1.884, P=0.000),
staging criteria (FIGO and TNM), and tumor staging (I-II and mixed
staging) all had an impact on DFS.Conclusion: The clinical application
of tumor budding as a prognostic factor of cervical cancer can be
considered.