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Tumor budding leads to vascular invasion and metastasis. The formation of tumor buds is thought to be the visible correlate of epithelial–mesenchymal transition (EMT) in the tumor microenvironment. Following tumor cell dissociation, lymphovascular invasion is frequently observed in high-grade budding tumors. TB could be a source of circulating cancer cells (CICs), leading to the establishment of metastasis at distant sites in the process of mesenchymal–epithelial transition (MET).
