期刊
GASTROENTEROLOGY
卷 144, 期 4, 页码 829-840出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.gastro.2013.01.001
关键词
Liver Cancer; Molecular Classification; Whole-Genome Profiling; Prognosis
资金
- Asociacion Espanola Contra el Cancer
- Instituto de Salud Carlos III [ISCIII/FIS FI10/00143, ISCIII/FIS FI09/00605]
- US National Cancer Institute [K08CA122833, U54CA143798]
- V Foundation Scholarship
- Instituto Carlos III [ISCIII/FIS PI 11/01830]
- Italian Association for Cancer Research
- Oncology Research Project of the Italian Ministry of Health
- US National Institute of Diabetes and Digestive and Kidney Diseases [1R01DK076986-01]
- European Commission [259744]
- Samuel Waxman Cancer Research Foundation
- Spanish National Health Institute [SAF-2010-16055]
- ICREA Funding Source: Custom
BACKGROUND & AIMS: Cholangiocarcinoma, the second most common liver cancer, can be classified as intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma. We performed an integrative genomic analysis of ICC samples from a large series of patients. METHODS: We performed a gene expression profile, high-density single-nucleotide polymorphism array, and mutation analyses using formalin-fixed ICC samples from 149 patients. Associations with clinicopathologic traits and patient outcomes were examined for 119 cases. Class discovery was based on a non-negative matrix factorization algorithm and significant copy number variations were identified by Genomic Identification of Significant Targets in Cancer (GISTIC) analysis. Gene set enrichment analysis was used to identify signaling pathways activated in specific molecular classes of tumors, and to analyze their genomic overlap with hepatocellular carcinoma (HCC). RESULTS: We identified 2 main biological classes of ICC. The inflammation class (38% of ICCs) is characterized by activation of inflammatory signaling pathways, overexpression of cytokines, and STAT3 activation. The proliferation class (62%) is characterized by activation of oncogenic signaling pathways (including RAS, mitogen-activated protein kinase, and MET), DNA amplifications at 11q13.2, deletions at 14q22.1, mutations in KRAS and BRAF, and gene expression signatures previously associated with poor outcomes for patients with HCC. Copy number variation-based clustering was able to refine these molecular groups further. We identified high-level amplifications in 5 regions, including 1p13 (9%) and 11q13.2 (4%), and several focal deletions, such as 9p21.3 (18%) and 14q22.1 (12% in coding regions for the SAV1 tumor suppressor). In a complementary approach, we identified a gene expression signature that was associated with reduced survival times of patients with ICC; this signature was enriched in the proliferation class (P < .001). CONCLUSIONS: We used an integrative genomic analysis to identify 2 classes of ICC. The proliferation class has specific copy number alterations, activation of oncogenic pathways, and is associated with worse outcome. Different classes of ICC, based on molecular features, therefore might require different treatment approaches.
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