Morphological classification of pancreatic ductal adenocarcinoma that predicts molecular subtypes and correlates with clinical outcome

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ..

INTRODUCTION: Transcriptional analyses have identified several distinct molecular subtypes in pancreatic ductal adenocarcinoma (PDAC) that have prognostic and potential therapeutic significance. However, to date, an indepth, clinicomorphological correlation of these molecular subtypes has not been performed. We sought to identify specific morphological patterns to compare with known molecular subtypes, interrogate their biological significance, and furthermore reappraise the current grading system in PDAC.

DESIGN: We first assessed 86 primary, chemotherapy-naive PDAC resection specimens with matched RNA-Seq data for specific, reproducible morphological patterns. Differential expression was applied to the gene expression data using the morphological features. We next compared the differentially expressed gene signatures with previously published molecular subtypes. Overall survival (OS) was correlated with the morphological and molecular subtypes.

RESULTS: We identified four morphological patterns that segregated into two components ('gland forming' and 'non-gland forming') based on the presence/absence of well-formed glands. A morphological cut-off (≥40% 'non-gland forming') was established using RNA-Seq data, which identified two groups (A and B) with gene signatures that correlated with known molecular subtypes. There was a significant difference in OS between the groups. The morphological groups remained significantly prognostic within cancers that were moderately differentiated and classified as 'classical' using RNA-Seq.

CONCLUSION: Our study has demonstrated that PDACs can be morphologically classified into distinct and biologically relevant categories which predict known molecular subtypes. These results provide the basis for an improved taxonomy of PDAC, which may lend itself to future treatment strategies and the development of deep learning models.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:69

Enthalten in:

Gut - 69(2020), 2 vom: 14. Feb., Seite 317-328

Sprache:

Englisch

Beteiligte Personen:

N Kalimuthu, Sangeetha [VerfasserIn]
Wilson, Gavin W [VerfasserIn]
Grant, Robert C [VerfasserIn]
Seto, Matthew [VerfasserIn]
O'Kane, Grainne [VerfasserIn]
Vajpeyi, Rajkumar [VerfasserIn]
Notta, Faiyaz [VerfasserIn]
Gallinger, Steven [VerfasserIn]
Chetty, Runjan [VerfasserIn]

Links:

Volltext

Themen:

Basal subtype
Classical subtype
Deep learning
Journal Article
Pancreatic ductal adenocarcinoma
Pattern-based morphological classification system

Anmerkungen:

Date Completed 29.01.2020

Date Revised 13.12.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1136/gutjnl-2019-318217

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM298178907