Genomic evidence supports a clonal diaspora model for metastases of esophageal adenocarcinoma

Menée à partir du séquençage du génome entier et de l'analyse phylogénétique de 388 échantillons tumoraux prélevés sur 18 patients atteints d'un adénocarcinome de l'œsophage, cette étude met en évidence un mode de dissémination se caractérisant par la rapidité de la progression tumorale et de la migration de sous-clones de cellules cancéreuses vers les ganglions lymphatiques et les tissus distants

Résumé en anglais

The poor outcomes in esophageal adenocarcinoma (EAC) prompted us to interrogate the pattern and timing of metastatic spread. Whole-genome sequencing and phylogenetic analysis of 388 samples across 18 individuals with EAC showed, in 90% of patients, that multiple subclones from the primary tumor spread very rapidly from the primary site to form multiple metastases, including lymph nodes and distant tissues—a mode of dissemination that we term ‘clonal diaspora’. Metastatic subclones at autopsy were present in tissue and blood samples from earlier time points. These findings have implications for our understanding and clinical evaluation of EAC.