食管癌变前期疾病阶段突变的排序

Ordering of mutations in preinvasive disease stages of esophageal carcinogenesis.

作者信息

Weaver Jamie M J, Ross-Innes Caryn S, Shannon Nicholas, Lynch Andy G, Forshew Tim, Barbera Mariagnese, Murtaza Muhammed, Ong Chin-Ann J, Lao-Sirieix Pierre, Dunning Mark J, Smith Laura, Smith Mike L, Anderson Charlotte L, Carvalho Benilton, O'Donovan Maria, Underwood Timothy J, May Andrew P, Grehan Nicola, Hardwick Richard, Davies Jim, Oloumi Arusha, Aparicio Sam, Caldas Carlos, Eldridge Matthew D, Edwards Paul A W, Rosenfeld Nitzan, Tavaré Simon, Fitzgerald Rebecca C

机构信息

MRC Cancer Unit, University of Cambridge, Cambridge, UK.

CRUK Cambridge Institute, University of Cambridge, Cambridge, UK.

出版信息

Nat Genet. 2014 Aug;46(8):837-843. doi: 10.1038/ng.3013. Epub 2014 Jun 22.

Abstract

Cancer genome sequencing studies have identified numerous driver genes, but the relative timing of mutations in carcinogenesis remains unclear. The gradual progression from premalignant Barrett's esophagus to esophageal adenocarcinoma (EAC) provides an ideal model to study the ordering of somatic mutations. We identified recurrently mutated genes and assessed clonal structure using whole-genome sequencing and amplicon resequencing of 112 EACs. We next screened a cohort of 109 biopsies from 2 key transition points in the development of malignancy: benign metaplastic never-dysplastic Barrett's esophagus (NDBE; n=66) and high-grade dysplasia (HGD; n=43). Unexpectedly, the majority of recurrently mutated genes in EAC were also mutated in NDBE. Only TP53 and SMAD4 mutations occurred in a stage-specific manner, confined to HGD and EAC, respectively. Finally, we applied this knowledge to identify high-risk Barrett's esophagus in a new non-endoscopic test. In conclusion, mutations in EAC driver genes generally occur exceptionally early in disease development with profound implications for diagnostic and therapeutic strategies.

摘要

癌症基因组测序研究已经鉴定出众多驱动基因,但致癌过程中突变的相对时间仍不清楚。从癌前巴雷特食管逐渐发展为食管腺癌(EAC),为研究体细胞突变的顺序提供了一个理想模型。我们通过对112例EAC进行全基因组测序和扩增子重测序,鉴定了反复突变的基因并评估了克隆结构。接下来,我们对来自恶性肿瘤发展过程中两个关键转变点的109份活检样本进行了筛查:良性化生未发育异常的巴雷特食管(NDBE;n = 66)和高级别发育异常(HGD;n = 43)。出乎意料的是,EAC中大多数反复突变的基因在NDBE中也发生了突变。只有TP53和SMAD4突变以阶段特异性方式发生,分别局限于HGD和EAC。最后,我们将这一知识应用于一项新的非内镜检查中,以识别高危巴雷特食管。总之,EAC驱动基因的突变通常在疾病发展的极早期就发生,这对诊断和治疗策略具有深远影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa77/4116294/7e5b6788b44e/emss-58861-f0001.jpg

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