Mutation heterogeneity between primary gastric cancers and their matched lymph node metastases

Gastric Cancer. 2019 Mar;22(2):323-334. doi: 10.1007/s10120-018-0870-6. Epub 2018 Aug 21.


Background: The acquisition of an invasive phenotype by a tumor cell is a crucial step of malignant transformation. The underlying genetic mechanisms in gastric cancer (GC) are not well understood.

Methods: We performed whole-exome sequencing of 15 pairs of primary GC and their matched lymph node (LN) metastases (10 primary GCs with single matched LNs and 5 primary GCs with three LNs per case, respectively). Somatic alterations including single nucleotide variations, short insertions/deletions including locus-level microsatellite instability and copy number alterations were identified and compared between the primary and metastatic LN genomes.

Results: Mutation abundance was comparable between the primary GC and LN metastases, but the extent of mutation overlap or the mutation heterogeneity between primary and LN genomes varied substantially. Primary- or LN-specific mutations could be distinguished from common mutations in terms of mutation spectra and functional categories, suggesting that the mutation forces are not constant during gastric carcinogenesis. A spatial distribution revealed TP53 mutations as common mutations along with a number of region-specific mutations, such as primary-specific SMARCA4 and LN-specific CTNNB1 mutations. The subclonal architectures of common mutations were largely conserved between primary GC and LN metastatic genomes. The mutation-based phylogenetic analyses further showed that LN metastases may have arisen from homogeneous subclones of primary tumors.

Conclusions: The abundance and spatial distribution of mutations may provide clues on the evolutionary relationship between primary and matched LN genomes. Gene-level analyses further distinguished the early addicted cancer drivers such as TP53 mutations from late acquired region-specific mutations.

Keywords: Evolution; Gastric cancers; Lymph node metastasis; Mutations; Sequencing.

MeSH terms

  • Aged
  • Aged, 80 and over
  • DNA Mutational Analysis
  • Female
  • Humans
  • Lymphatic Metastasis / genetics*
  • Lymphatic Metastasis / pathology*
  • Male
  • Middle Aged
  • Mutation
  • Stomach Neoplasms / genetics*
  • Stomach Neoplasms / pathology*