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食管腺癌中的胎儿肠细胞样分化定义具有治疗相关 claudin-6 阳性及 SWI/SNF 基因改变的罕见肿瘤亚型

英文原题:Fetal gut cell-like differentiation in esophageal adenocarcinoma defines a rare tumor subtype with therapeutically relevant claudin-6 positivity and SWI/SNF gene alteration.

PubMed 2024/06/12(内容时间) Sci Rep Q1 · IF 4.9(JCR 2025)

研究概要

我们的结果提示,按照胃癌分类,罕见肿瘤亚型可能应纳入 EAC 的 WHO 分类。

中文摘要

食管腺癌(EAC)是全球最致命的肿瘤类型之一,5 年生存率低于 25%。与其他肿瘤不同,EAC 的个体化治疗选择较少,部分原因是对特定亚组了解不足。本研究在包含 826 例患者的大型筛查队列中发现一个 EAC 患者亚组,其具有特定形态学和免疫组织化学特征,约占总体队列的 0.7%(6/826)。该亚组肿瘤细胞胞质呈显著透明状,并同时存在罕见生长模式,如卵黄囊样分化和肠胚层样分化。免疫组织化学显示胎儿肠细胞样蛋白 Sal 样蛋白 4(SALL4)、claudin-6 和磷脂酰肌醇蛋白聚糖 3 表达。有趣的是,该亚组与 SWI/SNF 复合体相关基因改变有关;这些基因在多种肿瘤类型中被认为发挥抑癌基因作用。研究结果提示,可参照胃癌分类,将罕见肿瘤亚型纳入 WHO 的 EAC 分类。此外,近期发表的 BNT-211-01 试验(NCT04503278)显示 claudin-6 阳性肿瘤对 CAR T 细胞疗法具有良好反应。这为该肿瘤亚型提供了一种个体化治疗选择。

展开英文摘要原文

Esophageal adenocarcinoma (EAC) is one of the deadliest tumor entities worldwide, with a 5-year survival rate of less than 25%. Unlike other tumor entities, personalized therapy options are rare, partly due to the lack of knowledge about specific subgroups. In this publication, we demonstrate a subgroup of patients with EAC in a large screening cohort of 826 patients, characterized by specific morphological and immunohistochemical features. This subgroup represents approximately 0.7% (6/826) of the total cohort. Morphological features of this subgroup show a striking clear cytoplasm of the tumour cells and the parallel existence of rare growth patterns like yolk sac-like differentiation and enteroblastic differentiation. Immunohistochemistry reveals expression of the fetal gut cell-like proteins Sal-like protein 4 (SALL4), claudin-6, and glypican 3. Interestingly, we find a correlation with alterations of SWI/SNF-complex associated genes, which are supposed to serve as tumor suppressor genes in various tumour entities. Our results suggest a possible implication of rare tumour subtypes in the WHO classification for EACs according to the classification for gastric cancer. Furthermore, claudin-6 positive tumors have shown promising efficacy of CAR T cell therapy in the recently published BNT-211-01 trial (NCT04503278). This represents a personalized therapeutic option for this tumor subtype.

论文信息

作者
Kraemer M、Zander T、Alakus H、Buettner R、Lyu SI、Simon AG、Schroeder W、Bruns CJ
单位
Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Gastrointestinal Cancer Group Cologne GCGC, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. max.kraemer@uk-koeln.de.Germany
期刊
Scientific reports2024 Jun 12
原文标识
PubMed 38866822 · DOI 10.1038/s41598-024-64116-2