Prognostic significance of tumor budding, desmoplastic reaction, and lymphocytic infiltration in patients with gastric adenocarcinoma

Figure 1 Tumor budding grades assessed according to International Tumor Budding Consensus Conference recommendations, desmoplastic reaction, and tumor-infiltrating lymphocytes. A: TB1 (1-4 tumor bud/hot spot), 200 ×; B: TB2 (5-9 tumor bud/hot spot), 200 ×; C: TB3 (10 tumor bud/hot spot), 200 ×; D: Desmoplastic reaction 1 (DR1), mature stroma composed of tightly packed collagen fibers, 400 ×; E: DR2, intermediate stroma, consisting of areas of collagen that resemble keloids, 400 ×; F: DR3, immature stroma with myxoid alterations; G: Gastric carcinoma with high TILs in tumor stroma (≥ 5%), 100 ×; H: Gastric carcinoma with low TILs (< 5 %), 100 ×. Hematoxylin-eosin, black arrows indicate tumor buds.

Figure 2 Scatter plot of Spearman’s rank correlation between peritumoral budding (vertical axis) and intratumoral budding (horizontal axis). A: Whole cohort B: Intestinal subgroup. ITB: Intratumoral budding.

Figure 3 Kaplan-Meier curves of survival analyses in the total cohort. A: Peritumoral budding (log-rank test P < 0.001); B: Intratumoral budding (log-rank test P < 0.001); C: The presence of lymph node metastasis (log-rank test P < 0.002): Desmoplastic reaction (log-rank test P < 0.002). PTB: Peritumoral budding; ITB: Intratumoral budding; LNM: Lymph node metastasis; DR: Desmoplastic reaction.

Figure 4 Kaplan-Meier curves of survival analyses in patients with an intestinal subtype of gastric adenocarcinoma. A: Peritumoral budding (log-rank test, P < 0.001); B: Intratumoral budding (log-rank test, P < 0.001); C: Desmoplastic reaction (log-rank test, P < 0.001); D: The presence of lymph node metastasis (log-rank test, P < 0.001). PTB: Peritumoral budding; ITB: Intratumoral budding; LNM: Lymph node metastasis; DR: Desmoplastic reaction.