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CLASSIFICATION
Classification
ITBCG tumor budding (BD1–BD3)
International Tumor Budding Consensus Conference (2016) grading of tumor buds at the invasive front of colorectal cancer. Count in one 0.785 mm² hotspot.
Classification overview
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ITBCG
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BD1 · Low budding (0–4 buds)
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BD2 · Intermediate budding (5–9 buds)
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BD3 · High budding (≥10 buds)
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Method · Counting method
ITBCG
BD1
Low budding (0–4 buds)
Zlobec 2021, Fig. 1, Not original, CC BY
Count
0–4 buds in one hotspot (0.785 mm²) at the invasive front
Reporting
Selective reporting acceptable in many protocols
Prognosis
Favourable compared with BD2/BD3
BD2
Intermediate budding (5–9 buds)
Zlobec 2021, Fig. 1, Not original, CC BY
Count
5–9 buds in one hotspot at the invasive front
Reporting
Mandatory reporting recommended (ITBCC)
Prognosis
Intermediate adverse prognostic factor
BD3
High budding (≥10 buds)
Zlobec 2021, Fig. 1, Not original, CC BY
Count
≥10 buds in one hotspot at the invasive front
Reporting
Mandatory reporting recommended (ITBCC)
Prognosis
High risk of LNM and poor outcome; may influence adjuvant therapy
Note: Associated with higher LNM risk in T1 colorectal cancer. Separate from the Kajiwara nomogram.
Method
Counting method
Bud
Single cell or cluster of ≤4 cells
Hotspot
0.785 mm² field at invasive front (20×, 0.5 mm diameter)
Stain
H&E (ITBCC standard)
Lugli 2017, Original
Zlobec 2021, Fig. 1, Not original, CC BY
Reference
Original article
Lugli A et al. Mod Pathol 2017;30:1299-1311 (ITBCC 2016)
Related tools
Colorectal T1 LNM nomogram (Kajiwara / JSCCR)
T1 LNM prediction (separate factor)
PREDICTION MODEL
T1 Nomogram
→
Vienna classification (GI epithelial neoplasia)
Vienna classification
CLASSIFICATION
Vienna
→
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.