Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer

Yihao Mao,1,* Qingyang Feng,1,2,* Peng Zheng,1,* Liangliang Yang,1,* Tianyu Liu,1 Yuqiu Xu,1 Dexiang Zhu,1,2 Wenju Chang,1,2 Meiling Ji,1,2 Li Ren,1,2 Ye Wei,1,2 Guodong He,1,2 Jianmin Xu1,2 1Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200030, China; 2Shanghai Engin...

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Main Authors: Mao Y, Feng Q, Zheng P, Yang L, Liu T, Xu Y, Zhu D, Chang W, Ji M, Ren L, Wei Y, He G, Xu J
Format: Article
Language:English
Published: Dove Medical Press 2018-09-01
Series:Cancer Management and Research
Subjects:
Online Access:https://www.dovepress.com/low-tumor-purity-is-associated-with-poor-prognosis-heavy-mutation-burd-peer-reviewed-article-CMAR
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author Mao Y
Feng Q
Zheng P
Yang L
Liu T
Xu Y
Zhu D
Chang W
Ji M
Ren L
Wei Y
He G
Xu J
author_facet Mao Y
Feng Q
Zheng P
Yang L
Liu T
Xu Y
Zhu D
Chang W
Ji M
Ren L
Wei Y
He G
Xu J
author_sort Mao Y
collection DOAJ
description Yihao Mao,1,* Qingyang Feng,1,2,* Peng Zheng,1,* Liangliang Yang,1,* Tianyu Liu,1 Yuqiu Xu,1 Dexiang Zhu,1,2 Wenju Chang,1,2 Meiling Ji,1,2 Li Ren,1,2 Ye Wei,1,2 Guodong He,1,2 Jianmin Xu1,2 1Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200030, China; 2Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive, Shanghai 200030, China *These authors contributed equally to this work Purpose: Tumor purity is defined as the proportion of cancer cells in the tumor tissue. The impact of tumor purity on colon cancer (CC) prognosis, genetic profile, and microenvironment has not been thoroughly accessed.Materials and methods: Clinical and transcriptomic data from three public datasets, GSE17536/17537, GSE39582, and TCGA, were retrospectively collected (n=1,248). Tumor purity of each sample was inferred by a computational method based on transcriptomic data. Survival-related analyses were performed on microarray dataset containing GSE17536/17537 and GSE39582 (n=794), whereas TCGA dataset was utilized for subsequent genomic analysis (n=454).Results: Right-sided CC patients showed a significantly lower tumor purity. Low purity CC conferred worse survival, and tumor purity was identified as an independent prognostic factor. Moreover, high tumor purity CC patients benefited more from adjuvant chemotherapy. Subsequent genomic analysis found that the mutation burden was negatively associated with tumor purity, with only APC and KRAS significantly more mutated in high purity CC. However, no somatic copy number alteration event was correlated with tumor purity. Furthermore, immune-related pathways and immunotherapy-associated markers (programmed cell death protein 1 [PD-1], programmed death-ligand 1 [PD-L1], cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], Lymphocyte-activation gene 3 [LAG-3] and T-cell immunoglobulin and mucin-domain containing-3 [TIM-3]) were highly enriched in low purity samples. Notably, the relative proportion of M2 macrophages and neutrophils, which indicated worse survival in CC, was negatively associated with tumor purity.Conclusion: Tumor purity exhibited potential value for CC prognostic stratification as well as adjuvant chemotherapy benefit prediction. The relative worse survival in low purity CC may attribute to higher mutation frequency in key pathways and purity-related microenvironmental changing. Keywords: adjuvant chemotherapy, colon cancer, prognosis, tumor microenvironment, tumor purity
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spelling doaj.art-6501b603720a4d2c9d2c57df5f3c05662022-12-22T01:27:27ZengDove Medical PressCancer Management and Research1179-13222018-09-01Volume 103569357740626Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancerMao YFeng QZheng PYang LLiu TXu YZhu DChang WJi MRen LWei YHe GXu JYihao Mao,1,* Qingyang Feng,1,2,* Peng Zheng,1,* Liangliang Yang,1,* Tianyu Liu,1 Yuqiu Xu,1 Dexiang Zhu,1,2 Wenju Chang,1,2 Meiling Ji,1,2 Li Ren,1,2 Ye Wei,1,2 Guodong He,1,2 Jianmin Xu1,2 1Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200030, China; 2Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive, Shanghai 200030, China *These authors contributed equally to this work Purpose: Tumor purity is defined as the proportion of cancer cells in the tumor tissue. The impact of tumor purity on colon cancer (CC) prognosis, genetic profile, and microenvironment has not been thoroughly accessed.Materials and methods: Clinical and transcriptomic data from three public datasets, GSE17536/17537, GSE39582, and TCGA, were retrospectively collected (n=1,248). Tumor purity of each sample was inferred by a computational method based on transcriptomic data. Survival-related analyses were performed on microarray dataset containing GSE17536/17537 and GSE39582 (n=794), whereas TCGA dataset was utilized for subsequent genomic analysis (n=454).Results: Right-sided CC patients showed a significantly lower tumor purity. Low purity CC conferred worse survival, and tumor purity was identified as an independent prognostic factor. Moreover, high tumor purity CC patients benefited more from adjuvant chemotherapy. Subsequent genomic analysis found that the mutation burden was negatively associated with tumor purity, with only APC and KRAS significantly more mutated in high purity CC. However, no somatic copy number alteration event was correlated with tumor purity. Furthermore, immune-related pathways and immunotherapy-associated markers (programmed cell death protein 1 [PD-1], programmed death-ligand 1 [PD-L1], cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], Lymphocyte-activation gene 3 [LAG-3] and T-cell immunoglobulin and mucin-domain containing-3 [TIM-3]) were highly enriched in low purity samples. Notably, the relative proportion of M2 macrophages and neutrophils, which indicated worse survival in CC, was negatively associated with tumor purity.Conclusion: Tumor purity exhibited potential value for CC prognostic stratification as well as adjuvant chemotherapy benefit prediction. The relative worse survival in low purity CC may attribute to higher mutation frequency in key pathways and purity-related microenvironmental changing. Keywords: adjuvant chemotherapy, colon cancer, prognosis, tumor microenvironment, tumor purityhttps://www.dovepress.com/low-tumor-purity-is-associated-with-poor-prognosis-heavy-mutation-burd-peer-reviewed-article-CMARadjuvant chemotherapycolon cancerprognosistumor microenvironmenttumor purity
spellingShingle Mao Y
Feng Q
Zheng P
Yang L
Liu T
Xu Y
Zhu D
Chang W
Ji M
Ren L
Wei Y
He G
Xu J
Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
Cancer Management and Research
adjuvant chemotherapy
colon cancer
prognosis
tumor microenvironment
tumor purity
title Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
title_full Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
title_fullStr Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
title_full_unstemmed Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
title_short Low tumor purity is associated with poor prognosis, heavy mutation burden, and intense immune phenotype in colon cancer
title_sort low tumor purity is associated with poor prognosis heavy mutation burden and intense immune phenotype in colon cancer
topic adjuvant chemotherapy
colon cancer
prognosis
tumor microenvironment
tumor purity
url https://www.dovepress.com/low-tumor-purity-is-associated-with-poor-prognosis-heavy-mutation-burd-peer-reviewed-article-CMAR
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