Stratification of colorectal cancer using a combination of molecular biology and digital pathology

This is particularly important given the increased number of early stage patients being diagnosed since the introduction of the bowel cancer screening programme. One such poor prognostic feature is tumour budding (TB), which will form the basis of the research within this thesis.<br><br>TB is the histological manifestation of local tumour cell dissemination, observed at the tumour invasive front, and despite being an established prognostic marker, inconsistent definitions and reporting guidelines have hindered routine use.

To improve TB detection and enumeration, a semi-automated classifier was developed, which compared favourably to a series of established manual methods, offering a freely available, rapid and transparent tool for TB assessment (Chapter 3). The TB classifier was independently validated within a novel cohort of pT1 tumours (n = 249), which represent a highly relevant setting, given that TB severity correlates to the presence of lymph node metastatic disease (Chapter 4).