Zhao Ruiying, Xu Yunhua, Chen Yedan, Zhang Jiajun, Teng Fei, Liao Sha, Chen Shengnan, Wu Qian, Xiang Chan, Pang Jiaohui, Shang Zhanxian, Zhao Jikai, Bao Hairong, Bao Hua, Shao Yang, Lu Shun, Han Yuchen
Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China.
Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China.
NPJ Precis Oncol. 2023 Aug 26;7(1):80. doi: 10.1038/s41698-023-00430-8.
The genomic origin and development of the biphasic lung adenosquamous carcinoma (ASC) remain inconclusive. Here, we derived potential evolutionary trajectory of ASC through whole-exome sequencing, Stereo-seq, and patient-derived xenografts. We showed that EGFR and MET activating mutations were the main drivers in ASCs. Phylogenetically, these drivers and passenger mutations found in both components were trunk clonal events, confirming monoclonal origination. Comparison of multiple lesions also revealed closer genomic distance between lymph node metastases and the ASC component with the same phenotype. However, as mutational signatures of EGFR-positive lung squamous carcinomas (LUSCs) were more comparable to EGFR-positive ASCs than to wild-type LUSCs, we postulated different origination of these LUSCs, with ASC being the potential intermediate state of driver-positive LUSCs. Spatial transcriptomic profiling inferred transformation from adenocarcinoma to squamous cell carcinoma, which was then histologically captured in vivo. Together, our results explained the development of ASC and provided insights into future clinical decisions.
双相肺腺鳞癌(ASC)的基因组起源和发展仍无定论。在此,我们通过全外显子测序、空间转录组测序(Stereo-seq)和患者来源的异种移植,推导了ASC的潜在进化轨迹。我们发现,EGFR和MET激活突变是ASC的主要驱动因素。从系统发育角度来看,在两个成分中发现的这些驱动突变和乘客突变均为树干克隆事件,证实了单克隆起源。对多个病灶的比较还显示,淋巴结转移灶与具有相同表型的ASC成分之间的基因组距离更近。然而,由于EGFR阳性肺鳞癌(LUSC)的突变特征与EGFR阳性ASC的更相似,而与野生型LUSC的差异较大,我们推测这些LUSC起源不同,ASC可能是驱动基因阳性LUSC的潜在中间状态。空间转录组分析推断了从腺癌到鳞状细胞癌的转变,随后在体内通过组织学方法得以证实。总之,我们的研究结果解释了ASC的发展过程,并为未来的临床决策提供了见解。