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通过组织-分子梯度分析恶性胸膜间皮瘤的异质性,以用于临床应用。

Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications.

机构信息

Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013, Paris, France.

Centre de Recherche des Cordeliers, Sorbonne Universités, Inserm, UMRS-1138, 75006, Paris, France.

出版信息

Nat Commun. 2019 Mar 22;10(1):1333. doi: 10.1038/s41467-019-09307-6.

Abstract

Malignant pleural mesothelioma (MPM) is recognized as heterogeneous based both on histology and molecular profiling. Histology addresses inter-tumor and intra-tumor heterogeneity in MPM and describes three major types: epithelioid, sarcomatoid and biphasic, a combination of the former two types. Molecular profiling studies have not addressed intra-tumor heterogeneity in MPM to date. Here, we use a deconvolution approach and show that molecular gradients shed new light on the intra-tumor heterogeneity of MPM, leading to a reconsideration of MPM molecular classifications. We show that each tumor can be decomposed as a combination of epithelioid-like and sarcomatoid-like components whose proportions are highly associated with the prognosis. Moreover, we show that this more subtle way of characterizing MPM heterogeneity provides a better understanding of the underlying oncogenic pathways and the related epigenetic regulation and immune and stromal contexts. We discuss the implications of these findings for guiding therapeutic strategies, particularly immunotherapies and targeted therapies.

摘要

恶性胸膜间皮瘤(MPM)在组织学和分子特征上均表现出异质性。组织学解决了 MPM 中的肿瘤间和肿瘤内异质性问题,并描述了三种主要类型:上皮样、肉瘤样和双相型,这是前两种类型的组合。迄今为止,分子特征研究尚未解决 MPM 中的肿瘤内异质性问题。在这里,我们使用去卷积方法表明,分子梯度为 MPM 的肿瘤内异质性提供了新的视角,促使我们重新考虑 MPM 的分子分类。我们发现,每个肿瘤都可以分解为上皮样样和肉瘤样样成分的组合,其比例与预后高度相关。此外,我们还发现,这种更细微的 MPM 异质性特征描述方法可以更好地理解潜在的致癌途径以及相关的表观遗传调控和免疫与基质环境。我们讨论了这些发现对指导治疗策略的意义,特别是免疫疗法和靶向疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7c8/6430832/0c2343074d7d/41467_2019_9307_Fig1_HTML.jpg

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