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. 2023 Jul 15;14:4239. doi: 10.1038/s41467-023-39957-6

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© 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 license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license 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 license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 8 — SBS17a/b processes show a relative decrease in the primary tumours compared to Barrett and metastasis cases, and can be used as markers of transformation early within Barrett Oesophagus. Frequent subclonal changes appear for this signature. SBS30 appears elevated in Barrett Oesophagus and primary tumours, and is linked with worse survival. Several signatures including SBS2 and SBS40 are most highly represented in primary tumours and can be used to distinguish this stage. DDR signatures specifically elevated at distinct points during OAC evolution are also highlighted. Links between signatures and prognosis/diagnosis are highlighted: SBS17a/b presence marks increased proliferation and progression after treatment, SBS30 is associated with worse prognosis, while SBS2 and SBS40 signatures could be used to specifically distinguish (diagnose) primary tumours. P = prognosis, D = diagnosis; HR = homologous recombination; NER = nucleotide excision repair; BER = base excision repair; TLS = translesion synthesis; MMR = mismatch repair.