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Ordering of mutations in preinvasive disease stages of esophageal carcinogenesis.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Weaver, Jamie MJ 
Ross-Innes, Caryn S 
Shannon, Nicholas 
Lynch, Andy G 
Forshew, Tim 

Abstract

Cancer genome sequencing studies have identified numerous driver genes, but the relative timing of mutations in carcinogenesis remains unclear. The gradual progression from premalignant Barrett's esophagus to esophageal adenocarcinoma (EAC) provides an ideal model to study the ordering of somatic mutations. We identified recurrently mutated genes and assessed clonal structure using whole-genome sequencing and amplicon resequencing of 112 EACs. We next screened a cohort of 109 biopsies from 2 key transition points in the development of malignancy: benign metaplastic never-dysplastic Barrett's esophagus (NDBE; n=66) and high-grade dysplasia (HGD; n=43). Unexpectedly, the majority of recurrently mutated genes in EAC were also mutated in NDBE. Only TP53 and SMAD4 mutations occurred in a stage-specific manner, confined to HGD and EAC, respectively. Finally, we applied this knowledge to identify high-risk Barrett's esophagus in a new non-endoscopic test. In conclusion, mutations in EAC driver genes generally occur exceptionally early in disease development with profound implications for diagnostic and therapeutic strategies.

Description

Keywords

Adenocarcinoma, Adult, Aged, Aged, 80 and over, Barrett Esophagus, Carcinogenesis, Esophageal Neoplasms, Female, Genome-Wide Association Study, Humans, Male, Middle Aged, Mutation, Precancerous Conditions, Sequence Analysis, DNA

Journal Title

Nat Genet

Conference Name

Journal ISSN

1061-4036
1546-1718

Volume Title

46

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Cancer Research Uk (None)
TCC (None)
Medical Research Council (MC_UU_12022/2)
Cancer Research UK (CB4140)
Department of Health (via National Institute for Health Research (NIHR)) (unknown)
Cancer Research UK (unknown)
Cancer Research UK (60098573)
Cancer Research UK (unknown)
Cancer Research Uk (None)
Cancer Research UK (unknown)
Cancer Research Uk (None)
Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
Cambridge University Hospitals NHS Foundation Trust (CUH) (RG51913)