Abstract
Adult cancers often arise from premalignant clonal expansions. Whether the same is true of childhood tumors has been unclear. To investigate whether Wilms tumor (nephroblastoma; a childhood kidney cancer) develops from a premalignant background, we examined the phylogenetic relationship between tumors and corresponding normal tissues. In 14 of 23 cases studied (61%), we found premalignant clonal expansions in morphologically normal kidney tissues that preceded tumor development. These clonal expansions were defined by somatic mutations shared between tumor and normal tissues but absent from blood cells. We also found hypermethylation of the H19 locus, a known driver of Wilms tumor development, in 58% of the expansions. Phylogenetic analyses of bilateral tumors indicated that clonal expansions can evolve before the divergence of left and right kidney primordia. These findings reveal embryonal precursors from which unilateral and multifocal cancers develop.
Original language | English |
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Pages (from-to) | 1247-1251 |
Number of pages | 5 |
Journal | Science |
Volume | 366 |
Issue number | 6470 |
DOIs | |
Publication status | Published - 6 Dec 2019 |
Bibliographical note
Funding Information:Funding: This project was principally funded by the Little Princess Trust, the St. Baldrick's Foundation (Robert J. Arceci International Award to S.B.), and Wellcome (fellowship to S.B.; Sanger core funding). Additional funding was received from CRUK (IMPORT study; fellowship to T.J.M.; Cambridge Centre), NIHR (Biomedical Research Centre Great Ormond Street; Cambridge Human Research Tissue Bank; Oxford Biomedical Research Centre; fellowship to T.R.W.O.), the Royal College of Surgeons of England (fellowship to T.J.M.), Wellcome (fellowship to T.H.H.C. and K.S.), Great Ormond Street Hospital Children's Charity (R.A.-S., K.P.-J.), and Li Ka Shing foundation (D.C.W.). J.D. acknowledges funding from the Alpe d'HuZes foundation/KWF Dutch Cancer Society Bas Mulder Award (#10218) and the Oncode Institute.
Publisher Copyright:
Copyright © 2019 The Authors.
ASJC Scopus subject areas
- General