{"entity":{"id":"paper-puleo-pancreatic-tumour-microenvironment-subtypes-gastroenterology-2018","kind":"paper","name":"Stratification of pancreatic ductal adenocarcinomas based on tumor and microenvironment features","aka":[],"tldr":"Using routine formalin-fixed tissue from 309 operations, this European study confirmed the classical and basal-like tumour types, added three microenvironment-defined groups, and showed the earlier exocrine-like type was contamination by normal acinar cells.","summary":"Formalin-fixed paraffin-embedded samples from 309 consecutive resections at four European hospitals underwent gene expression, targeted sequencing and immunohistochemistry. Independent component analysis deconvoluted normal, tumour and microenvironment patterns; consensus clustering after removing normal contamination defined subtypes, associated with survival and validated in TCGA and ICGC. The basal-like and classical tumour-specific subtypes were validated and five subtypes were defined: pure basal-like, stroma activated, desmoplastic, pure classical and immune classical. An exocrine signal was associated with acinar cell contamination, and the previously reported exocrine-like (ADEX) subtype was attributed to it.","asOf":"2026-09-24","links":[{"label":"Puleo et al., Gastroenterology 2018: five tumour and microenvironment subtypes in 309 resected cancers","url":"https://doi.org/10.1053/j.gastro.2018.08.033"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30165049/"}],"tags":[],"related":[],"cancers":["pancreatic","resectable-pdac"],"sections":[],"technologies":["rna-seq"],"targets":[],"drugs":[],"companies":[],"institutions":["institut-jules-bordet"],"pathways":["tumor-microenvironment","caf-activation-desmoplasia"],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["gastroenterology"],"dependsOn":[],"notes":[],"journal":"Gastroenterology","year":2018,"doi":"10.1053/j.gastro.2018.08.033","pmid":"30165049","authors":"Puleo F, Nicolle R, Blum Y, et al.","paperType":"translational","findings":["Five subtypes: pure basal-like, stroma activated, desmoplastic, pure classical, immune classical.","ADEX and exocrine-like reflect acinar contamination."],"whatItMeans":"It made subtyping possible on the archived tissue every hospital has, and it retired one of the four Bailey subtypes.","caveats":["Resected tumours only.","Subtypes are prognostic, not yet predictive."],"changedPractice":false,"participants":309},"route":"/key-papers/paper-puleo-pancreatic-tumour-microenvironment-subtypes-gastroenterology-2018/","neighbours":{"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"resectable-pdac","kind":"cancer","name":"Resectable pancreatic ductal adenocarcinoma","route":"/cancers/resectable-pdac/"}],"technology":[{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"}],"institution":[{"id":"institut-jules-bordet","kind":"institution","name":"Institut Jules Bordet","route":"/institutions/institut-jules-bordet/"}],"pathway":[{"id":"caf-activation-desmoplasia","kind":"pathway","name":"Fibroblast activation, desmoplasia & matrix stiffness","route":"/pathways/caf-activation-desmoplasia/"},{"id":"tumor-microenvironment","kind":"pathway","name":"Tumour microenvironment (TME)","route":"/pathways/tumor-microenvironment/"}],"journal":[{"id":"gastroenterology","kind":"journal","name":"Gastroenterology","route":"/journals/gastroenterology/"}]}}