The Genomic Landscape of Actinic Keratosis.

The Genomic Landscape of Actinic Keratosis.
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DOI:
10.1016/j.jid.2020.12.024
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发表时间:
2021-07
期刊:
The Journal of investigative dermatology
影响因子:
--
通讯作者:
Wang J
Wang J
中科院分区:
其他
文献类型:
--
作者:
Thomson J;Bewicke-Copley F;Anene CA;Gulati A;Nagano A;Purdie K;Inman GJ;Proby CM;Leigh IM;Harwood CA;Wang J

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光化性角化病 (AK) 是表皮角质形成细胞发育不良的病变,是侵袭性皮肤鳞状细胞癌 (cSCC) 的前兆。识别驱动从正常皮肤到 AK 皮肤到侵袭性 cSCC 皮肤进展的特定基因组改变具有挑战性,因为在这一进展的所有阶段都存在大量 UVR 诱导的突变负担特征。在这项研究中,我们报告了迄今为止最大的 AK 全外显子组测序研究,并对这些病变进行了突变特征和候选驱动基因分析。我们在来自免疫抑制和免疫功能正常患者的 37 个 AK 中证明,AK 和 cSCC 在突变负荷、拷贝数改变、突变特征和驱动基因突变模式方面存在显着相似性。我们鉴定了 44 个显着突变的 AK 驱动基因,并确认这些基因在 cSCC 中也发生了类似的改变。我们在接触该药物的患者的所有 AK 中鉴定了硫唑嘌呤突变特征,为其在角质形成细胞癌变中的作用提供了进一步的证据。 cSCC 与 AK 的不同之处在于具有更高水平的样本内异质性。信号通路的改变也有所不同,免疫相关信号传导和 TGFβ 信号传导在 cSCC 中明显发生更多突变。将我们的研究结果与独立的基因表达数据集相结合,证实 TGFβ 信号传导失调可能代表 AK-cSCC 进展中的一个重要事件。
Actinic keratoses (AKs) are lesions of epidermal keratinocyte dysplasia and are precursors for invasive cutaneous squamous cell carcinoma (cSCC). Identifying the specific genomic alterations driving the progression from normal skin to skin with AK to skin with invasive cSCC is challenging because of the massive UVR-induced mutational burden characteristic at all stages of this progression. In this study, we report the largest AK whole-exome sequencing study to date and perform a mutational signature and candidate driver gene analysis on these lesions. We demonstrate in 37 AKs from both immunosuppressed and immunocompetent patients that there are significant similarities between AKs and cSCC in terms of mutational burden, copy number alterations, mutational signatures, and patterns of driver gene mutations. We identify 44 significantly mutated AK driver genes and confirm that these genes are similarly altered in cSCC. We identify azathioprine mutational signature in all AKs from patients exposed to the drug, providing further evidence for its role in keratinocyte carcinogenesis. cSCCs differ from AKs in having higher levels of intrasample heterogeneity. Alterations in signaling pathways also differ, with immune-related signaling and TGFβ signaling significantly more mutated in cSCC. Integrating our findings with independent gene expression datasets confirms that dysregulated TGFβ signaling may represent an important event in AK‒cSCC progression.
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