Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma

ABSTRACT Background The progression and prognosis of early‐stage lung adenocarcinoma are closely associated with histologic subtypes, yet the presence of mixed histologic patterns often complicates prognostic assessment. Currently, the correlation between molecular and histologic features remains po...

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Main Authors: Hua Geng, Wenhao Zhou, Haitao Luo, Jiaqian Wang, Shixiong Li, Congcong Song, Yujie Zhao, Meilin Xu
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Clinical and Translational Medicine
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Online Access:https://doi.org/10.1002/ctm2.70439
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author Hua Geng
Wenhao Zhou
Haitao Luo
Jiaqian Wang
Shixiong Li
Congcong Song
Yujie Zhao
Meilin Xu
author_facet Hua Geng
Wenhao Zhou
Haitao Luo
Jiaqian Wang
Shixiong Li
Congcong Song
Yujie Zhao
Meilin Xu
author_sort Hua Geng
collection DOAJ
description ABSTRACT Background The progression and prognosis of early‐stage lung adenocarcinoma are closely associated with histologic subtypes, yet the presence of mixed histologic patterns often complicates prognostic assessment. Currently, the correlation between molecular and histologic features remains poorly understood. Methods Formalin‐fixed paraffin‐embedded (FFPE) samples were collected from patients with primary early‐stage lung adenocarcinoma, encompassing three histologic subtypes: well‐differentiated, moderately differentiated, and poorly differentiated. The GeoMx Digital Spatial Profiler platform was utilized to obtain spatial transcriptomic profiling. Regions of interest were carefully selected and further subdivided into three categories of areas of interest, specifically epithelial cell‐enriched regions, macrophage‐enriched regions, and other regions. Multiplex immunofluorescence (mIF) assays were employed to validate the obtained results. Results Distinct molecular characteristics were identified in tumor epithelial‐ and macrophage‐enriched compartments spanning well‐differentiated to poorly differentiated tumors. In poorly differentiated tumors, we observed enrichment of pathways related to humoral immune response, complement activation regulation, and extracellular matrix receptor interaction pathways, all of which are significantly associated with poorer prognosis. We integrated these pathways to develop a composite molecular signature that strongly correlate with adverse prognosis. Conclusions Our results provide new insights into the link between molecular and histologic subtypes in mixed‐type lung adenocarcinomas. Specifically, the identified molecular signatures offer potential biomarkers for predicting disease progression and prognosis, thus facilitating more precise and personalized therapeutic approaches. Key points Poorly differentiated components in mixed‐type early‐stage lung adenocarcinoma (LUAD) are characterized by enrichment of humoral immune response, complementactivation regulation, and extracellular matrix receptor interaction pathways, which areassociated with worse prognosis. A composite molecular signature integrating the keypathways strongly correlates with adverse clinical outcomes, serving as apotential prognostic biomarker. Digital spatial transcriptomics reveals spatially resolvedmolecular heterogeneity in tumor epithelial‐ and macrophage‐enrichedcompartments, bridging the gap between histologic subtypes and molecularmechanisms in LUAD.
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spelling doaj-art-facd8fe7992747caa1a06d853d983bc42025-08-25T18:28:45ZengWileyClinical and Translational Medicine2001-13262025-08-01158n/an/a10.1002/ctm2.70439Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinomaHua Geng0Wenhao Zhou1Haitao Luo2Jiaqian Wang3Shixiong Li4Congcong Song5Yujie Zhao6Meilin Xu7Department of Pathology Tianjin Chest Hospital Tianjin ChinaKindstar Global Precision Medicine Institute Shenzhen ChinaKindstar Global Precision Medicine Institute Shenzhen ChinaShenzhen Engineering Center for Translational Medicine of Precision Cancer Immunodiagnosis and Therapy YuceBio Technology Co., Ltd. Shenzhen ChinaDepartment of Pathology Tianjin Chest Hospital Tianjin ChinaShenzhen Engineering Center for Translational Medicine of Precision Cancer Immunodiagnosis and Therapy YuceBio Technology Co., Ltd. Shenzhen ChinaShenzhen Engineering Center for Translational Medicine of Precision Cancer Immunodiagnosis and Therapy YuceBio Technology Co., Ltd. Shenzhen ChinaDepartment of Pathology Tianjin Chest Hospital Tianjin ChinaABSTRACT Background The progression and prognosis of early‐stage lung adenocarcinoma are closely associated with histologic subtypes, yet the presence of mixed histologic patterns often complicates prognostic assessment. Currently, the correlation between molecular and histologic features remains poorly understood. Methods Formalin‐fixed paraffin‐embedded (FFPE) samples were collected from patients with primary early‐stage lung adenocarcinoma, encompassing three histologic subtypes: well‐differentiated, moderately differentiated, and poorly differentiated. The GeoMx Digital Spatial Profiler platform was utilized to obtain spatial transcriptomic profiling. Regions of interest were carefully selected and further subdivided into three categories of areas of interest, specifically epithelial cell‐enriched regions, macrophage‐enriched regions, and other regions. Multiplex immunofluorescence (mIF) assays were employed to validate the obtained results. Results Distinct molecular characteristics were identified in tumor epithelial‐ and macrophage‐enriched compartments spanning well‐differentiated to poorly differentiated tumors. In poorly differentiated tumors, we observed enrichment of pathways related to humoral immune response, complement activation regulation, and extracellular matrix receptor interaction pathways, all of which are significantly associated with poorer prognosis. We integrated these pathways to develop a composite molecular signature that strongly correlate with adverse prognosis. Conclusions Our results provide new insights into the link between molecular and histologic subtypes in mixed‐type lung adenocarcinomas. Specifically, the identified molecular signatures offer potential biomarkers for predicting disease progression and prognosis, thus facilitating more precise and personalized therapeutic approaches. Key points Poorly differentiated components in mixed‐type early‐stage lung adenocarcinoma (LUAD) are characterized by enrichment of humoral immune response, complementactivation regulation, and extracellular matrix receptor interaction pathways, which areassociated with worse prognosis. A composite molecular signature integrating the keypathways strongly correlates with adverse clinical outcomes, serving as apotential prognostic biomarker. Digital spatial transcriptomics reveals spatially resolvedmolecular heterogeneity in tumor epithelial‐ and macrophage‐enrichedcompartments, bridging the gap between histologic subtypes and molecularmechanisms in LUAD.https://doi.org/10.1002/ctm2.70439digital spatial transcriptomic profilingepithelial compartmentshistologic subtypeslung adenocarcinomamacrophage compartments
spellingShingle Hua Geng
Wenhao Zhou
Haitao Luo
Jiaqian Wang
Shixiong Li
Congcong Song
Yujie Zhao
Meilin Xu
Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
Clinical and Translational Medicine
digital spatial transcriptomic profiling
epithelial compartments
histologic subtypes
lung adenocarcinoma
macrophage compartments
title Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
title_full Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
title_fullStr Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
title_full_unstemmed Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
title_short Spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early‐stage lung adenocarcinoma
title_sort spatial transcriptomic analysis across histological subtypes reveals molecular heterogeneity and prognostic markers in early stage lung adenocarcinoma
topic digital spatial transcriptomic profiling
epithelial compartments
histologic subtypes
lung adenocarcinoma
macrophage compartments
url https://doi.org/10.1002/ctm2.70439
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