Abstract：
Tumour budding shows promise as a prognostic factor in various cancers, but its widespread application is hindered by the lack of large, validated studies and standardized criteria. This meta-analysis aims to review and examine the prognostic role of tumour budding specifically in noncolorectal gastrointestinal and pancreatobiliary tract cancers, broadening our perspective on its clinical relevance. The literature review was conducted through PubMed, Embase, and Web of Science from inception till 20 February 2023. Pooled odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated to assess the relation between tumour budding and clinicopathologic features, as well as overall survival. Each study was evaluated using the Newcastle-Ottawa Scale and both heterogeneity and publication bias were analysed. In this meta-analysis of 57 studies across various cancer types, multivariate HR revealed worse overall survival in oesophageal squamous cell carcinoma (HR 3.34 [95% CI 2.21-5.04]), gastric adenocarcinoma (2.03 [1.38-2.99]), pancreatic ductal adenocarcinoma (2.56 [2.02-3.25]), and biliary tract adenocarcinoma (3.11 [2.46-3.93]) with high-grade tumour budding. Additionally, high-grade tumour budding consistently correlated with adverse clinicopathological features, including lymph node metastasis, lymphovascular invasion, and distant metastasis without any observed inverse association. High heterogeneity was noted. Our study suggests that tumour budding is a valuable prognostic marker in various cancers. Nonetheless, standardized criteria tailored to specific organ types are necessary to enhance its clinical utility.
摘要：
肿瘤出芽显示出有望作为各种癌症的预后因素，但由于缺乏大量、经过验证的研究和标准化标准。这项荟萃分析旨在回顾和检查肿瘤出芽在非结肠直肠胃肠道和胰胆管癌中的预后作用。扩大我们对其临床相关性的看法。文献综述是通过PubMed进行的，Embase,和WebofScience从成立到2023年2月20日。计算具有95%置信区间(CI)的合并比值比(OR)和风险比(HR)以评估肿瘤出芽与临床病理特征之间的关系。以及总体生存率。使用纽卡斯尔-渥太华量表对每项研究进行评估，并对异质性和发表偏倚进行分析。在这项对不同癌症类型的57项研究的荟萃分析中，多变量HR显示食管鳞状细胞癌的总生存期较差(HR3.34[95%CI2.21-5.04])，胃腺癌（2.03[1.38-2.99]），胰腺导管腺癌（2.56[2.02-3.25]），和胆道腺癌（3.11[2.46-3.93]）伴高级别肿瘤出芽。此外,高级别肿瘤出芽与不良临床病理特征一致相关，包括淋巴结转移,淋巴管浸润,和远处转移，没有任何观察到的负相关。注意到高度异质性。我们的研究表明，肿瘤出芽是各种癌症中有价值的预后标志物。尽管如此，针对特定器官类型定制的标准化标准对于增强其临床效用是必要的。
