Figure - PMC

Skip to main content

An official website of the United States government

Here's how you know

Here's how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

View full-text article in PMC

. 2023 Apr 12;616(7957):534–542. doi: 10.1038/s41586-023-05729-x

Search in PMC
Search in PubMed
View in NLM Catalog
Add to search

© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

PMC Copyright notice

Fig. 3 — a, Definitions of the dissemination patterns of metastases at the case level, described relative to the primary tumour phylogeny. Grey arrows indicate the branches leading up to the seeding cluster(s). b, The most prevalent mode of metastatic dissemination observed is monoclonal monophyletic. Polyclonal ‘mixed’ represents cases in which a consensus dissemination pattern could not be inferred due to different possible phylogenetic tree topologies. c, At the sample level, polyclonal dissemination is more prevalent in primary LN/satellite lesions compared to recurrence/progression lesions (Fisher’s exact test, P = 0.03). d, Polyclonal dissemination is associated with a higher number of metastatic samples compared with monoclonal dissemination (median number of metastasis samples: 2 versus 1, respectively; Wilcoxon rank-sum test, P = 0.00078), sample number depicted as discrete values (left panel) or proportion (right panel). e, In cases where recurrence occurs, polyclonal dissemination is associated with extrathoracic metastasis, as identified on imaging, compared with monoclonal dissemination (n = 57 (monoclonal), n = 27 (polyclonal); Fisher’s exact test, P = 0.0056) f, Examples of cases with monoclonal (CRUK0559) and polyclonal polyphyletic (CRUK0484) dissemination patterns, both of which also demonstrate metastases being seeded from other sites of metastatic disease. The black arrows on the body map represent the routes of metastatic seeding (MACHINA). Each seeding cluster in the phylogenetic tree, as defined by our method, is assigned a unique colour that is also represented in the region clone maps. The timeline indicates the day on which the metastases were detected on imaging; the biopsy dates differ from this. For CRUK0559, the recurrence biopsy took place on day 188. For CRUK0484, the rib recurrence, scapula progression and brain progression were sampled at days 147, 433 and 582, respectively. The box plots represent the upper and lower quartiles (box limits), the median (centre line) and the vertical bars span the 5th to 95th percentiles. All tests were two-sided unless otherwise specified. LN, lymph node; RUL, right upper lobe; RLL, right lower lobe.