Clonality, Heterogeneity, and Evolution of Synchronous Bilateral Ovarian Cancer

癌症的体细胞进化 生物 遗传异质性 卵巢癌 癌变 癌症 外显子组测序 体细胞 外显子组 表型 突变 遗传学 癌症研究 基因
作者
Xia Yin,Ying Jing,Mei‐Chun Cai,Pengfei Ma,Yi Zhang,Cong Xu,Meiying Zhang,Wen Di,Guanglei Zhuang
出处
期刊:Cancer Research [American Association for Cancer Research]
卷期号:77 (23): 6551-6561 被引量:26
标识
DOI:10.1158/0008-5472.can-17-1461
摘要

Abstract Synchronous bilateral ovarian cancer (SBOC) represents a relatively frequent occurrence and clinically relevant diagnostic dilemma. Delineation of its clonal architecture, genetic heterogeneity, and evolutionary trajectories may have important implications for prognosis and management of patients with SBOC. Here, we describe the results of next-generation whole-exome or whole-genome sequencing of specimens from 12 SBOC cases and report that bilateral tumors from each individual display a comparable number of genomic abnormalities and similar mutational signatures of single-nucleotide variations. Clonality indices based on tumor-specific alterations supported monoclonal origins of SBOC. Each of the ovarian lesions was nevertheless oligoclonal, with inferred metastatic tumors harboring more subclones than their primary counterparts. The phylogenetic structure of SBOC indicated that most cancer cell dissemination occurred early, when the primary carcinoma was still relatively small (<100 million cells). Accordingly, the mutation spectra and mutational signatures of somatic variants exhibited pronounced spatiotemporal differences in each patient. Overall, these findings suggest that SBOCs are clonally related and form through pelvic spread rather than independent multifocal oncogenesis. Metastatic dissemination is often an early event, with dynamic mutational processes leading to divergent evolution and intratumor and intertumor heterogeneity, ultimately contributing substantially to phenotypic plasticity and diverse clinical course in SBOC. Cancer Res; 77(23); 6551–61. ©2017 AACR.
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