Journal: Nature Medicine
Article Title: Integrated epidemiological and molecular data inform the relationship between precancer and cancer states of esophageal adenocarcinoma
doi: 10.1038/s41591-026-04331-8
Figure Lengend Snippet: A . Patient selection workflow for spatial transcriptomics analysis. B . Spatial localization of transcriptional clusters in an EAC sample. Individual panels show the spatial distribution of the four primary Leiden clusters overlaid on the H&E-stained tissue section. Cluster 1 (blue) represents the main proliferative tumor compartment, marked by secretory and cell cycle–associated genes including REG1A and TOP2A, notably BE lineage genes were also markers of this cluster in EAC samples with and without adjacent BE. Cluster 2 (orange) corresponds to cytokine-producing tumor regions enriched for CCL20, CXCL8, and DUOX2. Cluster 3 (yellow) localizes to fibroblast-rich stromal regions, expressing ECM-associated genes such as COL1A1 and SPARC. Cluster 4 (red) highlights spatially confined tumor-immune interface regions, characterized by CD74, CXCL5, and MMP3. Composite overlay of all clusters demonstrates the mosaic-like spatial organization of transcriptional programs within the tissue, cluster 3 is represented in yellow for better visualization. Distinct zones of proliferative, inflammatory, stromal, and immune-interacting activity emerge. This case is shown as a representative example illustrating how spatial clustering resolves modular transcriptional architecture within an EAC sample. C . Comparison between unsupervised transcriptomic clustering and morphology-informed tissue classification in BE. Unsupervised transcriptomic clustering of the same tissue section identifies four distinct domains. In the left panel, Cluster 1 (blue) corresponds to canonical BE epithelium. Cluster 3 (green) defines a spatially confined epithelial patch with elevated CEACAM5, CEACAM6, and CLDN4, suggestive of early neoplastic transformation. Cluster 2 (orange) localizes to the columnar–squamous interface and expresses squamous markers (KRT5, KRT13) along with inflammatory genes (S100A8, S100A9), consistent with a reactive squamous phenotype. The region of high-grade dysplasia (HGD) was labeled. In the right panel, Spatial transcriptomics map of tissue compartments derived from morphology-aligned gene expression using Visium HD at 2 µm resolution. BE epithelium (light blue) expresses MUC2, TFF3, REG4, CDX2 consistent with intestinal metaplasia, while EAC regions (dark blue) are defined by expression of MKI67, SPINK1, EiRBB2, and CLDN4. Squamous epithelium (dark green) is defined by DSG3, KRT5, KRT14, and TP63. Stromal regions (light green) express ACTA2, PDGFRA, COL1A1, COL3A1, FAP, MMP2, and MMP9, indicating fibroblast activation and extracellular matrix remodeling.This case serves as a representative example demonstrating the spatial distribution of transcriptomic clusters within a BE sample containing.
Article Snippet: Spatial transcriptomics profiling was performed using the 10x Genomics Visium HD WT platform measuring approximately 18,000 genes, which achieves 2-μm resolution, enabling near-subcellular spatial granularity.
Techniques: Selection, Spatial Transcriptomics, Staining, Expressing, Activity Assay, Comparison, Transformation Assay, Labeling, Derivative Assay, Gene Expression, Activation Assay