Evidence for virus-mediated oncogenesis in bladder cancers arising in solid organ transplant recipients

  1. Gabriel J Starrett  Is a corresponding author
  2. Kelly Yu
  3. Yelena Golubeva
  4. Petra Lenz
  5. Mary L Piaskowski
  6. David Petersen
  7. Michael Dean
  8. Ajay Israni
  9. Brenda Y Hernandez
  10. Thomas C Tucker
  11. Iona Cheng
  12. Lou Gonsalves
  13. Cyllene R Morris
  14. Shehnaz K Hussain
  15. Charles F Lynch
  16. Reuben S Harris
  17. Ludmila Prokunina-Olsson
  18. Paul S Meltzer
  19. Christopher B Buck
  20. Eric A Engels
  1. CCR, NCI, NIH, United States
  2. DCEG, NCI, NIH, United States
  3. Leidos Biomedical Research Inc, United States
  4. Department of Medicine, Nephrology Division, Hennepin Healthcare System, University of Minnesota, United States
  5. Cancer Center, University of Hawaii, United States
  6. The Kentucky Cancer Registry, University of Kentucky, United States
  7. Department of Epidemiology and Biostatistics,and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
  8. Connecticut Tumor Registry, Connecticut Department of Public Health, United States
  9. California Cancer Reporting and Epidemiologic Surveillance Program, University of California, Davis, United States
  10. Cedars-Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, United States
  11. The Iowa Cancer Registry, University of Iowa, United States
  12. Howard Hughes Medical Institute, University of Minnesota, United States
6 figures, 2 tables and 2 additional files

Figures

Figure 1 with 3 supplements
Detection of viral sequences.

(A) Primary tumors. (B) Metastatic tumors. (C) Normal tissues. Viral species are shown on the rows, and each case in the cohort (represented with a TBC number) is a column. TBC numbers represent a single case and are consistent across primary, metastatic, and normal tissues. Circle size represents the breadth or fraction of the viral genome covered, and color represents the average depth of coverage of the viral k-mers with all coverages over 100 binned together. Specimens without sequencing data have a gray background.

Figure 1—figure supplement 1
BK polyomavirus (BKPyV) DNA/RNA coverage plots.

Coverage plots for BKPyV DNA (gray) and RNA (red) in BKPyV-positive tumors.

Figure 1—figure supplement 2
JC polyomavirus (JCPyV) DNA/RNA coverage plots.

Coverage plots for JCPyV DNA (gray) and RNA (red) in JCPyV-positive tumors.

Figure 1—figure supplement 3
All human papillomavirus (HPV) DNA/RNA coverage plots.

(A-D) Coverage plots for HPV DNA (gray) and RNA (red) in HPV16 (A), HPV20 (B), HPV28 (C), and HPV51 (D) -positive tumors. Diagrams of open reading frames for each respective type are below the coverage plots. (E) Annotated assembly graph of TBC11 HPV51. (F) Details of the top human BLASTn hits from the assembly in (E). (G) 1 kb upstream and downstream of TBC11 HPV51 predicted human integration junctions with genes and repeats annotated.

Virus diversity and integration.

(A) Phylogenetic tree of BK polyomavirus (BKPyV) large T antigen (LTag) sequences detected in tumors (red) and reference genotypes with representative strain names. (B) Sites of BKPyV integration into host chromosomes are indicated with case numbers. Two separate sections from separate formal-fixed paraffin-embedded (FFPE) blocks of the primary tumor were sequenced for case TBC03 (samples TBC03.1 and TBC03.2). Two separate sections were also sequenced for case TBC09, but an integration site was only detected in sample TBC09.1. Integration sites were also detected in normal tissue sample TBC09N. Black and gray bars indicate cytogenetic bands; red bars indicate centromeres. (C) Coverage plot of focal amplifications adjacent to BKPyV integration sites in cases TBC03.1, TBC03.2, TBC04, and TBC08. BKPyV integration junctions are indicated by a black arrow. Colored numbers in the body of the graph indicate coverage depth.

Figure 3 with 3 supplements
BK polyomavirus (BKPyV) DNA, RNA, and large T antigen (LTag) detection in tumors.

(A) Barplots showing the abundance of BKPyV DNA and RNA reads standardized to human reads (B) Barplots of histologically estimated percent tumor purity and Immunohistochemistry (IHC)-positivity for polyomavirus LTag expression. N.D. indicates no IHC image data were generated. (C) Representative coverage plots for BKPyV DNA (gray) and RNA (red) in BKPyV-positive tumors. Relative copy numbers are indicated by colored boxes and highlight the borders of duplications and deletions in the viral genome. (D) Selected images for LTag IHC highlighting positive staining for BKPyV-positive tumors with scale bars representing 500 microns.

Figure 3—figure supplement 1
BK polyomavirus (BKPyV) gene expression.

Heatmap of normalized expression (transcripts per million, TPM) of BKPyV genes per tumor.

Figure 3—figure supplement 2
Diagrams of the assembled BK polyomavirus (BKPyV) NCCR structures and rearrangements in tumors.

P=primary tumor, M=metastatic tumor.

Figure 3—figure supplement 3
T antigen immunohistochemistry (IHC) in BK polyomavirus (BKPyV)-positive tumors.

Selected images for T antigen IHC highlighting positive staining for BKPyV-positive tumors with a scale bar representing 500 microns.

Figure 4 with 2 supplements
Differential gene expression in BK polyomavirus (BKPyV)-positive tumors.

(A) Volcano plot of differential gene expression between BKPyV-positive and virus-negative tumors. Significantly differentially expressed genes (q-value <0.05, DESeq2) with a fold change greater than two are in red, and genes with a fold change less than two are in pink. Non-significant genes are in gray. (B) Variance stabilized counts for APOBEC3B expression from DESeq2 grouped by normal tissues, virus-negative tumors, and BKPyV-positive tumors showing significantly increased expression in BKPyV-positive tumors (Mann-Whitney U test). TBC01 is indicated by a red dot. (C) Heatmap of Z-scores of significantly differentially expressed genes and genes relevant to bladder cancer grouped by gene ontology. High expression is red, low expression is blue. Tumors names are colored by likely etiology: BKPyV-positive, red; JC polyomavirus (JCPyV)-positive, goldenrod; HR-HPV-positive, blue; torque teno virus (TTV)-positive, green; aristolochic acid, purple; undetermined, black; multiple colors reflect multiple detected viruses or etiologies. Tumors with evidence of integration are in italics. BKPyV LTag expression is shown as log10(transcripts per million [TPM]).

Figure 4—figure supplement 1
APOBEC3B germline variant and expression by BK polyomavirus (BKPyV) status.

Stabilized counts of APOBEC3B expression divided by tissue type (primary tumor, normal tissue), BKPyV status (BK), and germline variant rs1014971 status.

Figure 4—figure supplement 2
Host transcripts from the BK polyomavirus (BKPyV) integration site at BCAR3.

Coverage plots of DNA (gray) and RNA (red) from TBC03.1 and TBC03.2 on chromosome 1 at the BCAR3 locus.

Copy number variants.

Frequency plots for large copy number variants in BK polyomavirus (BKPyV)-positive tumors (panel A) and virus-negative tumors (panel C). Frequency of gains/amplifications is shown in red; losses/deletions are shown in blue. Sample level copy number variant spectra for BKPyV-positive tumors (panel B), virus-negative tumors (panel D), and all other tumors (panel E). Complete deletions are in dark blue and high copy amplifications are in red.

Figure 6 with 1 supplement
Somatic point mutations and mutation signature analysis.

(A) Tumor mutation burden (TMB, non-synonymous mutations per million bases) for each tumor in this study. Bars are colored by viral positivity (red, BK polyomavirus (BKPyV); green, TTV; blue, HR-HPV; goldenrod, JC polyomavirus (JCPyV)) or etiologic agent (aristolochic acid, purple; black, undetermined). Multiple colors reflect multiple detected viruses or etiologies. (B) Barplots of the contribution of each trinucleotide substitution for the four deconvoluted signatures with the likely mutation process indicated. (C) Proportion of each deconvoluted signature that contributes to each sample with virus status indicated by colored circles (red, BKPyV; green, TTV; blue, HR-HPV; goldenrod, JCPyV). (D) Number of unique and common trunk mutations in primary-metastatic tumor pairs and tumors with multi-region sequencing. For TBC03, TBC09, and TBC28, branches one and two refer to two separate areas of the same tumor. For TBC06 and TBC34, branches P and M refer to the primary tumor and metastasis, respectively. (E) Oncoprint for the top mutated genes in bladder cancers of transplant patients. Tumors IDs are colored by likely etiology: BKPyV-positive, red; JCPyV-positive, goldenrod; HR-HPV-positive, blue; TTV-positive, green; aristolochic acid, purple; undetermined, black. The percent of modified tumors is shown on the left and the count of the variants in each gene is represented by the barplot on the right.

Figure 6—figure supplement 1
Mutations signature deconvolution.

(A) Residual sum of squares and explained variance for 2–10 signatures deconvoluted by SomaticSignatures. (B) Barplot of base substitution contributions to each of the four deconvoluted signatures from SomaticSignatures. (C) Heatmap of cosine similarities of four signatures deconvoluted by Somatic Signatures versus known Single Base Substitution Signatures (SBS). (D) NMF rank survey results for 2–10 signature deconvolution by MutationalPatterns. (E) Barplot of base substitution contributions to each of the four deconvoluted signatures from MutationalPatterns. (F) Heatmap of cosine similarities of four signatures deconvoluted by MutationalPatterns versus known SBS with closest matches highlighted in red.

Tables

Table 1
Characteristics of post-transplant bladder cancer cases (N=43).
CharacteristicStatistic
MedianIQR
Age in years at diagnosis6560, 71
Years from transplant to diagnosis5.83, 7
N%
Sex
Female1330
Male3070
Transplanted organ
Kidney2456
Liver49
Heart and/or lung1433
Pancreas12
Race
Non-Hispanic White3070
Asian/Pacific Islander819
Hispanic512
Summary stage
In situ1228
Localized1946
Regional714
Distant512
Grade
Low2047
High2251
Papillary urothelial neoplasm of low malignant potential12
  1. IQR: interquartile range.

Table 2
BK polyomavirus (BKPyV) integrations sites and microhomology.
IDHuman sequence matchVirus sequence matchMaximum MH lengthMH sequenceChromosomePositionNearest gene (Symbol)Nearest gene (Ensembl ID)Distance to Nearest GeneNearest REDistance to nearest RE
TBC02CATCATGATGATGGGGATGGGCAGCCTA5ATGGGchr2120378301INHBBENSG00000163083–26499MIRb–45
TBC02CTCCTGCTCATGAACATGAAGGT
TAAGCATGCTA
5ATGAAchr4145732354C4orf51ENSG000002371360AluSq2–474
TBC02ACCATTTAATTCCCAAAGTGGAAATTAC2ACchr4145732375C4orf51ENSG000002371360AluSq2–495
TBC03.1GCCTTTCTTG
TGGACTGGGT
ATTTTCATTTCT
ACTGGGGTCAGGA
0No overlapchr193693546BCAR3ENSG000001379360MIRb377
TBC03.1TCTGTTTCT
TATTTCAGAA
GGGTTCTCCTG
TTTATAAGGTC
2TCchr193693570BCAR3ENSG000001379360MIRb353
TBC03.1AGAGCCTTG
GTGGTGG
GGTGGCAAA
CAGTGCAG
5GGTGGchr193693890BCAR3ENSG000001379360MIRb33
TBC03.1GATACTTTTT
AGACATGC
AACCATGACC
TCAGGAAGGA
4CATGchr193694075BCAR3ENSG000001379360MIRb0
TBC03.1CCTCAAAGC
CACCCACTCC
TTTCCATGA
GCCCCAAA
5CCAAAchr193694843BCAR3ENSG000001379360MER5A–92
TBC03.1CAATTTTTTTTTTTTTTTTTTTATT
TGTAAGGGTG
7TTTTTTTchr1250449935LARP4ENSG000001618130AluSc0
TBC03.1TGCAAGGTG
CTTCATGTAT
AGGGGGCTTA
AAGGATGCA
4TGCAchr1495764390ENSG00000257275–6735MIRb0
TBC03.1TAGCCAAAA
AAAAAAAGG
AAAAAAAAA
GGCCACAG
11AAAAAAAAAGGchr208525269PLCB1ENSG000001826210MamSINE1154
TBC03.1CAATTTGGA
AAACAAT
ATGCAAGGG
CAGTGCACA
2ATchr373059264PPP4R2ENSG000001636050MER103C69
TBC03.1TAAAAAGTGTCAAAGTGTCAA
TAGAGAAAAA
8AAGTGTCAchr4142307350INPP4BENSG000001094520L2a0
TBC03.1TCACACAAT
TT-TACTCCTCT
ACACTTTTTAC
ACTCCTCTA
8ACTCCTCTchr8140923993PTK2ENSG000001693980L2a0
TBC03.2GTTGAGTT
GGAGCA
CATCTAAATAA
TCTCTCAAACT
2CAchr193693160BCAR3ENSG000001379360MER5A1–10
TBC03.2ACCCAGTCCA
CAAGAAAGGC
CCAGTAGAA
ATGAAAAT
0No overlapchr193693546BCAR3ENSG000001379360MIRb377
TBC03.2TCTGTTTCT
TATTTCAG
GTTCTCCTGT
TTATAAGGTC
2TCchr193693570BCAR3ENSG000001379360MIRb353
TBC04GAGTGAGT
TCATAG
CAACACTGTG
GTGAG-TGAGTT
4GAGTchr35202593EDEM1ENSG000001341090L2b–466
TBC06CAGACATT
-AGGA
TGAGGACC
TAACCTGT
4AGGAchr2201676427MPP4ENSG000000821260MIR1_Amn0
TBC08TCCACTTT
CAGTACTT
TGCAAAA
AATCAAAT
1Tchr6148535326SASH1ENSG000001119610AluSq995
TBC09.1GGGGCGG
TAACTAGAAG
ACTAGAAG
CTTGTCGT
8ACTAGAAGchr1761340185BCAS3ENSG000001413760L2-3_Crp0
TBC09NGAGAAAAT
AGGACTCGG
AAGATTCGC
CTGAGAAAA
7GAGAAAAchr188169205PTPRMENSG000001734820MER127–648
TBC09NTCCATCC
TCCTCTAC
CTCCTCT
ACATTGT
9CTCCTCTACchr334028749LINC01811ENSG00000226320130585L2b0
TBC09NATGTAAT
ATAAAACT
CATGATT
TTAACCCAG
0No overlapchr3117678477ENSG000002392680L2c0
  1. MH: microhomology; RE: Repeat element.

Additional files

Supplementary file 1

Supporting information.

(a) Checkerboard table of samples used in this study. (b) Sequencing metrics. (c) Reference sequences used in this study. (d) Tumor torque teno virus similarities. (e) BKPyV-positive tumor vs virus-free tumor significantly differentially expressed genes. (f) Non-synonymous point mutations. (g) Copy number variants.

https://cdn.elifesciences.org/articles/82690/elife-82690-supp1-v2.xlsx
MDAR checklist
https://cdn.elifesciences.org/articles/82690/elife-82690-mdarchecklist1-v2.docx

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  1. Gabriel J Starrett
  2. Kelly Yu
  3. Yelena Golubeva
  4. Petra Lenz
  5. Mary L Piaskowski
  6. David Petersen
  7. Michael Dean
  8. Ajay Israni
  9. Brenda Y Hernandez
  10. Thomas C Tucker
  11. Iona Cheng
  12. Lou Gonsalves
  13. Cyllene R Morris
  14. Shehnaz K Hussain
  15. Charles F Lynch
  16. Reuben S Harris
  17. Ludmila Prokunina-Olsson
  18. Paul S Meltzer
  19. Christopher B Buck
  20. Eric A Engels
(2023)
Evidence for virus-mediated oncogenesis in bladder cancers arising in solid organ transplant recipients
eLife 12:e82690.
https://doi.org/10.7554/eLife.82690