对食道癌进行基因分析有助于临床试验

根据美国的一个大型研究，食道癌或食管癌的两种主要类型，呈现出不同的遗传特点，在临床实验上应该进行有区别的研究。

来自癌症基因组图谱（TCGA）研究网的分析，对疾病的分类提出了质疑。

   “专家确信这项研究对未来临床研究的设计可能有影响，作为正在运行的临床试验和开发新药物的‘参考手册’”，来自美国达纳-法伯癌症研究所的首席研究员Adam Bass博士说。

肿瘤通常是根据癌细胞在显微镜下如何表现和在世界中发生的情况来分类。

食道癌长期以来被分为两种主要类别：看起来像胃癌和大肠癌的腺癌；与一些肺癌、皮肤癌，和头颈癌类似的麟状细胞癌。

但是很少人知道这些癌症在分子或者遗传水平方面是如何不同的。

为了发现更多情况，研究人员利用来自癌症基因组图谱中公开的数据-协作的努力来了解更多关于癌症的遗传学-研究559个食道癌和胃癌样本。

这个研究发表在《自然》杂志的期刊上，发现食管腺癌和鳞状细胞癌在遗传学上是截然不同的。他们同样也发现在食管上部出现的癌症呈现出和头颈癌的分子相似性，然而那些进一步沿着食管的癌症和一种胃癌非常相似。

研究团队认为，因为这些研究成果，临床试验应该根据他们分子子型对患者进行分类，美国癌症研究院的食道癌专家Rebecca Fitzgerald教授同意这一观点。

   “这是迄今为止对食管癌全面的遗传分析，”她说。“而且它提供比以前任何时候更多的关于这种疾病不同类型的分子特征的细节”。

   “这个研究成果发现食管癌的两种主要类型-鳞状细胞癌和腺癌-是不同的，这并不奇怪，并得到其它研究的支持。”

   “但这项研究清楚地表明，这些不同类型的食管癌患者不应该放在相同的临床试验中。”

   “我们当中的许多人提出这个研究成果有很长一段时间。因此，这项新研究应该帮助医生确保这些亚组在未来的试验中被分离。”

Large genetic analysis of oesophageal cancer could lead to better clinical trials

    The two main types of oesophageal, or food pipe cancer, display distinct genetic characteristics and should be studied separately in clinical trials, according to a large US study.

    The analysis from The Cancer Genome Atlas (link is external) (TCGA) Research Network calls into question the classification of the disease.

Experts believe the study could have implications for the design of future clinical studies, serving as a “reference manual” for those running clinical trials and developing new drugs, said lead researcher Dr Adam Bass from the Dana-Farber Cancer Institute in the US.

    Tumours are commonly classified based on how the cancer cells look under the microscope and where the cases occur in the world.

Oesophageal cancer has long been split into two main categories: adenocarcinomas, which look like stomach or bowel cancers; and squamous cell carcinomas, which are similar to some lung, skin, and head and neck cancers.

But little has been known about how these cancers differ at the molecular, or genetic level.

    To find out more, the researchers used publicly available data from TCGA – a collaborative effort to understand more about the genetics of cancer – to study 559 oesophageal and stomach cancer samples.

    Published in the journal Nature (link is external), the study found that oesophageal adenocarcinomas and squamous cell carcinomas are genetically distinct. They also found that cancers occurring in the upper region of the oesophagus display molecular similarities to cancers of the head and neck, while those further down the food pipe closely resemble a type of stomach cancer.

    The research team argues that because of these findings, clinical trials should group oesophageal cancer patients based on their molecular sub-type, something which Professor Rebecca Fitzgerald, a Cancer Research UK expert in oesophageal cancer, agrees with.

   “This is the most comprehensive genetic analysis of oesophageal cancer to date,” she said. “And it provides more detail on the molecular characteristics of the different types of the disease than was previously available.

   “The finding that the two main types of oesophageal cancer – squamous cell and adenocarcinoma – are distinct is not surprising, and is supported by other studies.

   “But this study makes it clear that patients with these different types of oesophageal cancer shouldn’t be put in the same arm of clinical trials.

   “This is something that many of us have been suggesting for a long time. So this latest study should help doctors ensure that these subgroups are separated in future trials.”

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