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Multi-parametric atlas of the pre-metastatic liver for prediction of metastatic outcome in early-stage pancreatic cancer
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Weill Cornell Med, NY 10065 USA.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Mem Sloan Kettering Canc Ctr, NY USA; Rutgers Canc Inst New Jersey, NJ USA.ORCID iD: 0000-0003-2740-3259
Mem Sloan Kettering Canc Ctr, NY USA; NCI, MD USA.
Mem Sloan Kettering Canc Ctr, NY USA; Mem Sloan Kettering Canc Ctr, NY 10065 USA.
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2024 (English)In: Nature Medicine, ISSN 1078-8956, E-ISSN 1546-170X, Vol. 30, no 8, p. 2170-2180Article in journal (Refereed) Published
Abstract [en]

Metastasis occurs frequently after resection of pancreatic cancer (PaC). In this study, we hypothesized that multi-parametric analysis of pre-metastatic liver biopsies would classify patients according to their metastatic risk, timing and organ site. Liver biopsies obtained during pancreatectomy from 49 patients with localized PaC and 19 control patients with non-cancerous pancreatic lesions were analyzed, combining metabolomic, tissue and single-cell transcriptomics and multiplex imaging approaches. Patients were followed prospectively (median 3 years) and classified into four recurrence groups; early (<6 months after resection) or late (>6 months after resection) liver metastasis (LiM); extrahepatic metastasis (EHM); and disease-free survivors (no evidence of disease (NED)). Overall, PaC livers exhibited signs of augmented inflammation compared to controls. Enrichment of neutrophil extracellular traps (NETs), Ki-67 upregulation and decreased liver creatine significantly distinguished those with future metastasis from NED. Patients with future LiM were characterized by scant T cell lobular infiltration, less steatosis and higher levels of citrullinated H3 compared to patients who developed EHM, who had overexpression of interferon target genes (MX1 and NR1D1) and an increase of CD11B(+) natural killer (NK) cells. Upregulation of sortilin-1 and prominent NETs, together with the lack of T cells and a reduction in CD11B(+) NK cells, differentiated patients with early-onset LiM from those with late-onset LiM. Liver profiles of NED closely resembled those of controls. Using the above parameters, a machine-learning-based model was developed that successfully predicted the metastatic outcome at the time of surgery with 78% accuracy. Therefore, multi-parametric profiling of liver biopsies at the time of PaC diagnosis may determine metastatic risk and organotropism and guide clinical stratification for optimal treatment selection.<br />

Place, publisher, year, edition, pages
NATURE PORTFOLIO , 2024. Vol. 30, no 8, p. 2170-2180
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-206593DOI: 10.1038/s41591-024-03075-7ISI: 001258625300006PubMedID: 38942992Scopus ID: 2-s2.0-85197913692OAI: oai:DiVA.org:liu-206593DiVA, id: diva2:1890937
Note

Funding Agencies|National Cancer Institute [CA224175, CA210240, CA232093, CA163117, CA207983, CA163120, CA169416, CA169538, CA218513, AI144301]; US Department of Defense [W81XWH-13-1-0425, W81XWH-13-1-0427, W81XWH-13-1-0249, W81XWH-14-1-0199, W81XWH-21-1-0978]; National Institutes of Health/WCM CTSC (NIH/NCATS) [UL1TR00457]; NIH/NCATS [UL1TR002384]; Hartwell Foundation; Thompson Family Foundation; STARR Consortium [I9-A9-056, I8-A8-123]; Pediatric Oncology Experimental Therapeutics Investigator's Consortium; Alex's Lemonade Stand Foundation; Breast Cancer Research Foundation; Feldstein Medical Foundation; Tortolani Foundation; Clinical & Translational Science Center; Mary Kay Ash Charitable Foundation; Malcolm Hewitt Weiner Foundation; Manning Foundation; Daniel P. and Nancy C. Paduano Family Foundation; James Paduano Foundation; Sohn Foundation; AHEPA Vth District Cancer Research Foundation; Daedalus Fund; Atossa Therapeutics; Children's Cancer and Blood Foundation; Swedish Cancer Society [21 1824 Pj 01 H]; Swedish Research Society [2021-0235]; Swedish Society for Medical Research [S21-0079]; Alan and Sandra Gerry Metastasis and Tumor Ecosystems Center of Memorial Sloan Kettering Cancer Center; Conquer Cancer Foundation of the American Society of Clinical Oncology; National Institutes of Health [R01CA234614, R01DK121072]; Paul G. Allen Family Foundation [UWSC13448]; Selma and Lawrence Ruben Science to Industry Bridge Award; [CCSG P30 CA008748-53]

Available from: 2024-08-21 Created: 2024-08-21 Last updated: 2025-08-14Bibliographically approved

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Bojmar, LindaVelasco Riestra, PaulinaBlomstrand, HakonBjörnsson, BergthorSandström, Per A

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Bojmar, LindaZambirinis, ConstantinosBurman, JonasVelasco Riestra, PaulinaBlomstrand, HakonJönsson, CarolinJönsson, AnetteBjörnsson, BergthorSandström, Per A
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesClinical pathologyDepartment of Biomedical and Clinical SciencesDepartment of Surgery in Linköping
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