<p>Tumor budding is a detectable histopathological feature and has been recognized as an adverse prognostic factor in several human cancers. However, there are few reports on the prognostic value of tumor budding (TB) in tongue squamous cell carcinoma (TSCC). We assessed the correlation of tumor budding with the clinicopathologic features and evaluated its prognostic significance for TSCC. A stage I-II TSCC that surgically resected at Osaka Dental University Hospital was used in this study, as well as 30 other cases, 19 of which were highly differentiated and 11 of which were poorly differentiated. Ten of the cases showed late lymph node metastasis (LM). The group without LM was considered LM-negative, and the LM group was considered LM-positive. As histopathological endpoints, the WHO grade classification and TBs were evaluated, and their association with LM was examined. Moreover, we evaluated the number of TBs in one field of view and divided them into those with less than 5 TBs and those with more than 5. The number of TBs increased in areas where the tumor invasive front (IF) was unclear. In addition, grade 1 had fewer TBs, and grade 3 tended to have more. The overall number of the TBs ranged from 0 to 15, with a median (interquartile range) of 5 (2-7.25). When grouped by the presence or absence of LM, the median value (interquartile range) in the LM-negative group was 3 (1.75-5), while in the LM-positive group it was 10.5 (6.5-13), indicating significantly increased TB in the LM-positive group (Mann-Whitney U test, p<0.01). Statistically, Grade classification (p=0.007) and TB (p=0.033) were risk factors for LM by Fisher's exact test. Therefore, it was suggested that TB may indicate a high risk, and may be a predictor of LM. (J Osaka Dent Univ 2024; 58: 111-115)</p>