Immunohistochemical Expression of “HCG-β” in Colorectal Carcinoma

Amira Mohamed Bassam; Yousra Raafat; Ahmed Mahmoud Abd Al-Aziz; Rasha Ramadan Mostafa

doi:10.3889/oamjms.2021.6854

Authors

Amira Mohamed Bassam Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Yousra Raafat Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt https://orcid.org/0000-0002-8208-5559
Ahmed Mahmoud Abd Al-Aziz Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Rasha Ramadan Mostafa

DOI:

https://doi.org/10.3889/oamjms.2021.6854

Keywords:

Colorectal carcinoma, Human chorionic gonadotropin-beta, Tumor budding, Immunohistochemistry

Abstract

BACKGROUND: Tumor budding is associated with adverse histology and is a predictor of lymph node metastasis. Human chorionic gonadotropin-beta (hCG-β) expression in non-trophoblastic tumors has been associated with aggressive behavior.

AIM: Evaluation of tumor budding and hCG-β _immunohistochemical expression in colorectal carcinoma (CRC), and correlation of their expression with various clinicopathological parameters.

MATERIALS AND METHODS: Immunohistochemical staining for hCG-β _was performed on paraffin-embedded sections of 60 cases of CRC. Tumors with cytoplasmic or membranous staining of more than five epithelial cell clusters were designated hCG-β _positive; otherwise, they were designated hCG-β _negative. Tumor budding was assessed in hematoxylin and eosin stained slides and was classified as; low: 0–4 buds, intermediate: 5–9 buds and high: ≥10 buds; with exclusion of pure mucoid or signet ring cell morphology cases from analysis.

RESULTS: Tumor budding was low in (58.8%) of the cases, intermediate in (15.7%), and high in (25.5%). There was a statistically significant correlation between tumor budding and tumor histological grade (p = 0.011), lymph node metastasis (N) (p = 0.009), overall pathologic stage group (p = 0.009), modified Dukes’ stage (p = 0.009), lymphovascular invasion (p = 0.000), and desmoplastic reaction (p = 0.004). Positive hCG-β _alpha expression was detected in 12 (20%) of cases. There were statistically significant correlations between hCG-β _expression and each of lymphovascular invasion (p = 0.042) and tumor budding (p = 0.000).

CONCLUSION: hCG-β _is a marker of aggressiveness that may have essential role in tumor invasion. Tumor budding is crucial event in tumor invasion and metastasis. Tumor budding with hCG-β _expression is a novel prognostic parameter and may represent a potential therapeutic target.

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