Ordering of mutations in preinvasive disease stages of esophageal carcinogenesis

the OCCAMS Consortium, Jamie M.J. Weaver, Caryn S. Ross-Innes, Nicholas Shannon, Andy G. Lynch, Tim Forshew, Mariagnese Barbera, Muhammed Murtaza, Chin Ann J. Ong, Pierre Lao-Sirieix, Mark J. Dunning, Laura Smith, Mike L. Smith, Charlotte L. Anderson, Benilton Carvalho, Maria O'donovan, Timothy J. Underwood, Andrew P. May, Nicola Grehan, Richard HardwickJim Davies, Arusha Oloumi, Sam Aparicio, Carlos Caldas, Matthew D. Eldridge, Paul A.W. Edwards, Nitzan Rosenfeld, Simon Tavaré, Rebecca C. Fitzgerald*, Stephen J. Hayes, Ang Yeng, Anne Marie Lydon, Soney Dharmaprasad, Sandra Greer, Shaun Preston, Sarah Oakes, Vicki Save, Simon Paterson-Brown, Olga Tucker, Derek Alderson, Philippe Taniere, Jamie Kelly, James Byrne, Donna Sharland, Nina Holling, Lisa Boulter, Fergus Noble, Bernard Stacey, Charles Crichton, Hugh Barr, Neil Shepherd

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

274 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)837-843
Number of pages7
JournalNature Genetics
Volume46
Issue number8
Early online date22 Jun 2014
DOIs
Publication statusPublished - Aug 2014

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