Histological assessment of budding and depth of invasion (BD) model in biopsies of oral squamous cell carcinoma

Abstract

Objectives: Recognizing precise prognosticators from preoperative biopsies that aids in treatment is of immense clinical importance. Thus, the aim of this study was to assess andcompare the tumor budding (B), depth of invasion (D) and combined scores (BD) model in the preoperative biopsies and subsequent postoperative specimens of oral squamous cellcarcinoma (OSCC). Material and Methods: B and D were assessed in the pre- and postoperative specimens of 65 OSCC cases treated in the institution. Relationship between pre- andpostoperative assessments was subjected to McNemar's, Chi-square, Fisher's exact, sensitivity and specificity statistics. Results: There was an agreement between the pre- andpostoperative B scores in 54 cases with accuracy of 83% (95% confidence interval 71.73%–91.24%). The preoperative scores showed a good sensitivity of 67.86% and a high specificityof 94.59% in predicting the postoperative score of the same. The difference in assessing intensity B as low and high between preoperative and postoperative biopsies was not statisticallydifferent. There was an agreement between the pre- and postoperative scores of the BD model in 72%. The difference in BD scoring as low intermediate and high between preoperativeand postoperative biopsies were significantly different statistically. Postoperative BD scoring showed a significant association with stage and lymph node metastasis. Conclusions: Thefindings validate the prognostic value of BD model in the postoperative specimens. Its value in preoperative biopsies is questionable. A judicious representative biopsy may increase theaccuracy and reliability in the assessment of preoperative B and precision in BD model evaluation