Objective Colorectal cancer (CRC) is one of the most prevalent malignant tumors worldwide, posing a significant threat to human health. Tumor budding (TB), as a critical pathological feature of CRC, is closely associated with tumor invasion, metastasis, and prognosis. MethodsThis review synthesizes recent advances in TB research within CRC. Through a systematic analysis of the literature,it focuses on elucidating the pathological processes and molecular mechanisms underlying TB formation,highlighting its complex interplay with the tumor microenvironment. The review also summarizes methodologies for TB counting and grading, spanning from conventional histopathological evaluation to innovative approaches leveraging radiomics and artificial intelligence. ResultsTB play an essential role in clinical decision-making for CRC patients, demonstrating how TB grade influences surgical strategy selection and the planning of neoadjuvant and adjuvant therapies. Additionally, TB is also a key prognostic indicator of CRC, high-grade TB being consistently associated with increased risk of recurrence and reduced survival rate. Future research should further unravel the molecular mechanisms of TB, refine TB assessment methodologies,and validate the clinical utility of TB in personalized treatment strategies through multicenter trials. These efforts are expected to improve therapeutic outcomes and prognosis for CRC patients.
ObjectiveTo investigate the correlations among the cadual homeobox gene 2 (CDX2), hypoxia inducible factor-1α (HIF-1α) protein expressions, and tumor budding in the colorectal cancer (CRC). MethodsIn this study, 63 CRC specimens surgically removed in the First Affiliated Hospital of Xi’an Jiaotong University from January 2012 to September 2015 were collected. The CDX2 and HIF-1α protein expressions were detected by immunohistochemical staining streptavidin-biotin peroxidase two-step method. The staining and the grade of tumor budding were observed under an optical microscope, and the correlation was analyzed using Spearman test. ResultsThe positive expressions of CDX2 and HIF-1α proteins in the CRC tissues were 35 (55.6%) and 47 (74.6%) cases, respectively, which was a negative correlation in the CRC (rs=–0.302, P=0.017). The positive expressions of CDX2 and HIF-1α proteins in the tumor budding of colorectal cancer were 21 (51.2%) and 26 (63.4%) cases, respectively, which was also a negative correlation in the tumor budding of CRC (rs=–0.336, P=0.031), but there was no statistic correlation between the grade of tumor budding and CDX2 or HIF-1α positive protein expression in the CRC (rs=0.113, P=0.370; rs=–0.026, P=0.838). ConclusionsThe positive expression between CDX2 and HIF-1α has a negative correlation in the same CRC specimen and which has a negative correlation in tumor budding. There is no statistic correlation between grade of tumor budding and CDX2 or HIF-1α protein expression in the CRC. Hypoxia environment may be involved in the downregulation of CDX2 level during the malignant progression of CRC.