ABSTRACT
The worldwide incidence of pulmonary carcinoids is increasing, but little is known about their molecular characteristics. Through machine learning and multi-omics factor analysis, we compare and contrast the genomic profiles of 116 pulmonary carcinoids (including 35 atypical), 75 large-cell neuroendocrine carcinomas (LCNEC), and 66 small-cell lung cancers. Here we report that the integrative analyses on 257 lung neuroendocrine neoplasms stratify atypical carcinoids into two prognostic groups with a 10-year overall survival of 88% and 27%, respectively. We identify therapeutically relevant molecular groups of pulmonary carcinoids, suggesting DLL3 and the immune system as candidate therapeutic targets; we confirm the value of OTP expression levels for the prognosis and diagnosis of these diseases, and we unveil the group of supra-carcinoids. This group comprises samples with carcinoid-like morphology yet the molecular and clinical features of the deadly LCNEC, further supporting the previously proposed molecular link between the low- and high-grade lung neuroendocrine neoplasms.
Subject(s)
Biomarkers, Tumor/genetics , Carcinoid Tumor/genetics , Carcinoma, Large Cell/genetics , Lung Neoplasms/genetics , Small Cell Lung Carcinoma/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoid Tumor/mortality , Carcinoid Tumor/pathology , Carcinoma, Large Cell/mortality , Carcinoma, Large Cell/pathology , Comparative Genomic Hybridization , Datasets as Topic , Female , Genomics , Homeodomain Proteins/genetics , Humans , Intracellular Signaling Peptides and Proteins/genetics , Lung/pathology , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Machine Learning , Male , Membrane Proteins/genetics , Middle Aged , Nerve Tissue Proteins/genetics , Prognosis , Small Cell Lung Carcinoma/mortality , Small Cell Lung Carcinoma/pathology , Survival Rate , Young AdultABSTRACT
BACKGROUND: Today, sequencing is frequently carried out by Massive Parallel Sequencing (MPS) that cuts drastically sequencing time and expenses. Nevertheless, Sanger sequencing remains the main validation method to confirm the presence of variants. The analysis of MPS data involves the development of several bioinformatic tools, academic or commercial. We present here a statistical method to compare MPS pipelines and test it in a comparison between an academic (BWA-GATK) and a commercial pipeline (TMAP-NextGENe®), with and without reference to a gold standard (here, Sanger sequencing), on a panel of 41 genes in 43 epileptic patients. This method used the number of variants to fit log-linear models for pairwise agreements between pipelines. To assess the heterogeneity of the margins and the odds ratios of agreement, four log-linear models were used: a full model, a homogeneous-margin model, a model with single odds ratio for all patients, and a model with single intercept. Then a log-linear mixed model was fitted considering the biological variability as a random effect. RESULTS: Among the 390,339 base-pairs sequenced, TMAP-NextGENe® and BWA-GATK found, on average, 2253.49 and 1857.14 variants (single nucleotide variants and indels), respectively. Against the gold standard, the pipelines had similar sensitivities (63.47% vs. 63.42%) and close but significantly different specificities (99.57% vs. 99.65%; p < 0.001). Same-trend results were obtained when only single nucleotide variants were considered (99.98% specificity and 76.81% sensitivity for both pipelines). CONCLUSIONS: The method allows thus pipeline comparison and selection. It is generalizable to all types of MPS data and all pipelines.
