PanCuRx Translational Research Initiative, Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada; Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada.
PanCuRx Translational Research Initiative, Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada.
Cancer Cell. 2019 Feb 11;35(2):267-282.e7. doi: 10.1016/j.ccell.2018.12.010. Epub 2019 Jan 24.
We integrated clinical, genomic, and transcriptomic data from 224 primaries and 95 metastases from 289 patients to characterize progression of pancreatic ductal adenocarcinoma (PDAC). Driver gene alterations and mutational and expression-based signatures were preserved, with truncations, inversions, and translocations most conserved. Cell cycle progression (CCP) increased with sequential inactivation of tumor suppressors, yet remained higher in metastases, perhaps driven by cell cycle regulatory gene variants. Half of the cases were hypoxic by expression markers, overlapping with molecular subtypes. Paired tumor heterogeneity showed cancer cell migration by Halstedian progression. Multiple PDACs arising synchronously and metachronously in the same pancreas were actually intra-parenchymal metastases, not independent primary tumors. Established clinical co-variates dominated survival analyses, although CCP and hypoxia may inform clinical practice.
我们整合了 289 名患者的 224 个原发性肿瘤和 95 个转移性肿瘤的临床、基因组和转录组数据,以研究胰腺导管腺癌 (PDAC) 的进展。驱动基因改变以及突变和表达谱特征得以保留,截断、倒位和易位最为保守。随着肿瘤抑制基因的连续失活,细胞周期进展 (CCP) 增加,但转移瘤中的 CCP 仍然更高,这可能是由细胞周期调节基因变异驱动的。半数病例通过表达标志物呈缺氧状态,与分子亚型重叠。配对肿瘤异质性显示出由哈尔斯特德进展驱动的癌细胞迁移。同一胰腺中同时或先后发生的多个 PDAC 实际上是实质内转移,而不是独立的原发性肿瘤。尽管 CCP 和缺氧可能为临床实践提供信息,但既定的临床协变量仍然主导着生存分析。