Histological assessment of budding, depth of invasion, and grading in oral squamous cell carcinoma: Correlation with regional metastasis

Abstract

Background: Assessment of budding and grading of oral squamous cell carcinoma (OSCC)
establishes the prerequisite for its management as the first step toward personalized management.
The inclusion of depth of invasion (DOI) and its regional metastasis provides a holistic approach
to the treatment of this devastating lesion.
Materials and Methods: The present study is a descriptive analytical study of 80 diagnosed
cases of OSCC. Only OSCC cases with both preoperative and corresponding postoperative tissue
sections, along with relevant clinical information, were included in the study.
Results: The budding and depth (BD) score demonstrated strong predictive accuracy for lymph
node metastasis (LNM), with a sensitivity of 83.3% and specificity of 70.0%. The positive predictive
value was 76.9%, whereas the negative predictive value was 77.8%. The 95% confidence interval
ranged from 0.65 to 0.85, underscoring the reliability of this predictive model. These findings highlight
the BD score as a valuable tool for anticipating LNM. Correlation analysis revealed significant
relationships between BD scores and several clinical parameters. The budding score showed a
moderate correlation with tumor size (r = 0.45) and lymph node involvement (r = 0.60), both
statistically significant at P < 0.05. Similarly, the DOI exhibited significant correlations with tumor
size (r = 0.55) and lymph node involvement (r = 0.65). Chi‑square test employed to calculate P value.
P <0.05 was considered statistically significant.
Conclusion: The results indicate a strong correlation between higher BD scores and greater
lymph node involvement, as well as deeper tumor invasion, pointing to more aggressive tumor
characteristics, proving it to be an effective tool for clinical prognosis.
Key Words: Budding, depth of invasion, oral squamous cell carcinoma, tumor grading

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Mohammed Abidullah: Pubmed,Google Scholar