侵袭性早期肺腺癌的特征是上皮细胞具有可塑性,获得了干细胞样特征和免疫逃避表型。
Aggressive early-stage lung adenocarcinoma is characterized by epithelial cell plasticity with acquirement of stem-like traits and immune evasion phenotype.
机构信息
Cancer Biomarkers Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
出版信息
Oncogene. 2021 Aug;40(31):4980-4991. doi: 10.1038/s41388-021-01909-z. Epub 2021 Jun 25.
Lung adenocarcinoma (LUAD) is the main non-small-cell lung cancer diagnosed in ~40-50% of all lung cancer cases. Despite the improvements in early detection and personalized medicine, even a sizable fraction of patients with early-stage LUAD would experience disease relapses and adverse prognosis. Previous reports indicated the existence of LUAD molecular subtypes characterized by specific gene expression and mutational profiles, and correlating with prognosis. However, the biological and molecular features of such subtypes have not been further explored. Consequently, the mechanisms driving the emergence of aggressive LUAD remained unclear. Here, we adopted a multi-tiered approach ranging from molecular to functional characterization of LUAD and used it on multiple cohorts of patients (for a total of 1227 patients) and LUAD cell lines. We investigated the tumor transcriptome and the mutational and immune gene expression profiles, and we used LUAD cell lines for cancer cell phenotypic screening. We found that loss of lung cell lineage and gain of stem cell-like characteristics, along with mutator and immune evasion phenotypes, explain the aggressive behavior of a specific subset of lung adenocarcinoma that we called C1-LUAD, including early-stage disease. This subset can be identified using a 10-gene prognostic signature. Poor prognosis patients appear to have this specific molecular lung adenocarcinoma subtype which is characterized by peculiar molecular and biological features. Our data support the hypothesis that transformed lung stem/progenitor cells and/or reprogrammed epithelial cells with CSC characteristics are hallmarks of this aggressive disease. Such discoveries suggest alternative, more aggressive, therapeutic strategies for early-stage C1-LUAD.
肺腺癌(LUAD)是约 40-50%的所有肺癌病例中诊断出的主要非小细胞肺癌。尽管早期检测和个性化医疗有所改进,但即使是相当一部分早期 LUAD 患者也会经历疾病复发和不良预后。先前的报告表明,存在 LUAD 分子亚型,其特征是特定的基因表达和突变谱,并与预后相关。然而,这些亚型的生物学和分子特征尚未进一步探索。因此,驱动侵袭性 LUAD 出现的机制仍不清楚。在这里,我们采用了从分子到 LUAD 的功能特征的多层次方法,并在多个患者队列(总共 1227 名患者)和 LUAD 细胞系上使用了它。我们研究了肿瘤转录组和突变及免疫基因表达谱,并使用 LUAD 细胞系进行了癌细胞表型筛选。我们发现,肺细胞谱系的丧失和干细胞样特征的获得,以及突变体和免疫逃逸表型,解释了特定亚组 LUAD 的侵袭性行为,我们称之为 C1-LUAD,包括早期疾病。可以使用 10 个基因预后签名来识别这一亚组。预后不良的患者似乎具有这种特定的分子肺腺癌亚型,其特征是独特的分子和生物学特征。我们的数据支持这样一种假设,即转化的肺干细胞/祖细胞和/或具有 CSC 特征的重编程上皮细胞是这种侵袭性疾病的标志。这些发现为早期 C1-LUAD 提供了替代的、更具侵袭性的治疗策略。