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Intra-prostatic tumour evolution, steps in metastatic spread and histogenomic associations revealed by integration of multi-region whole-genome sequencing with histopathological features

Abstract:

Background: Extension of prostate cancer beyond the primary site by local invasion or nodal metastasis is associated with poor prognosis. Despite significant research on tumour evolution in prostate cancer metastasis, the emergence and evolution of cancer clones at this early stage of expansion and spread are poorly understood. We aimed to delineate the routes of evolution and cancer spread within the prostate and to seminal vesicles and lymph nodes, linking these to histological features that are used in diagnostic risk stratification.

Methods: We performed whole-genome sequencing on 42 prostate cancer samples from the prostate, seminal vesicles and lymph nodes of five treatment-naive patients with locally advanced disease. We spatially mapped the clonal composition of cancer across the prostate and the routes of spread of cancer cells within the prostate and to seminal vesicles and lymph nodes in each individual by analysing a total of > 19,000 copy number corrected single nucleotide variants.

Results: In each patient, we identified sample locations corresponding to the earliest part of the malignancy. In patient 10, we mapped the spread of cancer from the apex of the prostate to the seminal vesicles and identified specific genomic changes associated with the transformation of adenocarcinoma to amphicrine morphology during this spread. Furthermore, we show that the lymph node metastases in this patient arose from specific cancer clones found at the base of the prostate and the seminal vesicles. In patient 15, we observed increased mutational burden, altered mutational signatures and histological changes associated with whole genome duplication. In all patients in whom histological heterogeneity was observed (4/5), we found that the distinct morphologies were located on separate branches of their respective evolutionary trees.

Conclusions: Our results link histological transformation with specific genomic alterations and phylogenetic branching. These findings have implications for diagnosis and risk stratification, in addition to providing a rationale for further studies to characterise the genetic changes causally linked to morphological transformation. Our study demonstrates the value of integrating multi-region sequencing with histopathological data to understand tumour evolution and identify mechanisms of prostate cancer spread.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s13073-024-01302-x

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Surgical Sciences
Role:
Author
ORCID:
0000-0003-1889-6530
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Surgical Sciences
Role:
Author
ORCID:
0000-0002-4905-8233
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Surgical Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Surgical Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Role:
Author


More from this funder
Funder identifier:
https://ror.org/029chgv08
Grant:
203141/Z/16/Z
More from this funder
Funder identifier:
https://ror.org/04dkv6329
Grant:
PA14-022
More from this funder
Funder identifier:
https://ror.org/054225q67
Grant:
A18444
C1380
25812


Publisher:
Springer
Journal:
Genome Medicine More from this journal
Volume:
16
Issue:
1
Article number:
35
Publication date:
2024-02-19
Acceptance date:
2024-02-06
DOI:
EISSN:
1756-994X
Pmid:
38374116


Language:
English
Keywords:
Pubs id:
1624500
Local pid:
pubs:1624500
Deposit date:
2025-04-09
ARK identifier:

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