Tumor Budding in Upper Gastrointestinal Carcinomas: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Gastrointestinal (GI) carcinomas represent a heterogeneous composition of malignancies that stem from the organs of the GI tract. They are among the most prevalent and are associated with high mortality alongside morbidity rates. This study utilized the guidelines set forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), whereby four medical databases were searched for relevant scholarly publications published between 2010 and 2024. These databases were PubMed, Web of Science, and ScienceDirect. Risk of bias (RoB) for cohort, case-controlled, and cross-sectional studies was assessed using the Newcastle-Ottawa Scale (NOS), whereas randomized controlled trials (RCTs) used the Cochrane (RoB) tool. With the assumption that the observed estimate of the treatment effect differs between the included studies, a random effect meta-analysis was carried out. In the meta-analysis, fifteen trials with 7607 patients were considered. The findings indicate a substantial correlation between high-grade tumor budding and tumor stage, (χ²=480472.97, P<0.00001) with a mean difference of -6.18 at 95% confidence interval (95% CI) (-14.66 to 2.30), tumor differentiation (χ²=23.31, P<0.00001) with a mean difference of -12.60 at 95% CI (-35.89 to 10.68), lymph vascular invasion (χ²=29.59, P<0.00001) with a mean difference of -5.03 at 95% CI (-11.26 to 1.21), and lymph node metastasis (χ²=158.30, P<0.00001) with a mean difference of -3.44 at 95% CI (-4.72, -1.78). Furthermore, in upper gastrointestinal (UGI) patients, high-grade tumor budding was associated with a negative five-year overall survival (P<0.00001) and a mean difference of -0.09 at 95% CI (-0.20 to 0.02). In regards to the risk of bias, most of the retrospective, prospective, case-control, and cohort studies 10/14 were of satisfactory quality. Moreover, 5/7 of the clinical trials had a low risk of bias. However, the funnel plot indicated that there is a probability of publication bias in favor of tumor budding. The study revealed a significant link between tumor budding and key prognostic factors-overall survival, lymph node metastasis, tumor differentiation, and lymphovascular invasion-in upper gastrointestinal carcinomas. High-grade tumor budding is associated with poor clinicopathological characteristics and a five-year overall survival. Tumor budding may serve as a unique prognostic marker. To confirm these results, further research with larger preoperative UGI biopsies is recommended.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.057 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".