A 2021 publication by Rico et al. demonstrates the power of multiomics profiling.1 The study aim was to identify potential gene drivers and unique signaling pathways of DGASTs. DGASTs have been reported to occur in submucosal Brunner’s glands (BGs) of the duodenum.2 BGs however do not express GI hormones, and so DGASTs located in these glands must have a different tumor driver than found in other GI tumors.1
FFPE tissues (both tumor and normal) were analyzed by: (1) RNA sequencing for differential gene expression; (2) whole exome sequencing for SNPs and indels; (3) immunohistochemistry (IHC) for expression and cellular localization of proteins of interest; (4) Digital Spatial Profiling (DSP) (NanoString) to view expression patterns in spatial context, i.e. tumor cells and cells proximal that may provide clues to tumorigenesis; (5) qPCR for confirmation of differential gene expression.
This spatial multiomics study led to a hypothesis for the mechanism driving the development of DGASTs from normal tissue, as well as a potential therapeutic not previously considered for this disease subtype: