Target sequencing of cancer-related genes in early esophageal squamous neoplasia resected by endoscopic resection in Japanese patients.

BACKGROUND AND AIMS

Next generation sequencing (NGS) has revealed a great deal about cancer-related somatic changes in esophageal squamous cell neoplasia; however, the changes in the very early stages remain unclear.

RESULTS

(87%) and (20%) hot spot mutations were frequently found in early lesions. was the most common mutation (LGIN/HGIN, 86%; EP, 83%; LPM, 95%; MM/SM1, 80%), followed by (29%, 28%, 16% and 10%, respectively); the frequency of other mutations increased as the disease advanced ( < 0.01). Copy number variation analysis revealed copy number aberrations in multiple genes, including amplification (48%). NGS was superior to p53 immunostaining for detecting mutations (74% vs. 87%); in combination, the two tests improved detectability to 94%. Clinically, smoking was associated with the occurrence of mutations in these early lesions ( = 0.049).

MATERIALS AND METHODS

Fifty-four early esophageal neoplasia lesions from 47 patients treated by endoscopic resection (low-grade intraepithelial neoplasia [LGIN], 1; high-grade intraepithelial neoplasia [HGIN] 7; invasion limited to epithelium [EP/M1], 18; lamina propria mucosae [LPM/M2], 19; muscularis mucosae [MM/M3], 8; and upper third of the SM [SM1], 2) were isolated from formalin-fixed paraffin-embedded tissue specimens by laser-capture microdissection. Target sequencing of 50 cancer-related genes was performed with an Ion Proton sequencer; their association with the clinical characteristics was investigated.

CONCLUSIONS

Mutations of and , and amplification were common in early esophageal squamous neoplasia, while other mutations accumulated with disease progression. An understanding of these molecular events might provide a molecular basis for early lesion treatment.