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. 2025 Aug 22;11(34):eadw7680. doi: 10.1126/sciadv.adw7680

Table 1. Distribution of PTCs by the pattern of DNA damage that generated the driver.

Alternative end-joining (alt-EJ), base pair (bp), DNA double-strand break (DNA DSB), nonhomologous end-joining (NHEJ), papillary thyroid carcinoma (PTC), single-strand annealing (SSA), structural variant (SV), The Cancer Genome Atlas (TCGA), and whole-genome sequencing (WGS).

Chornobyl Tissue Bank* TCGA (n = 69)
Driver type Comments Total (n = 355) 131I-exposed (n = 285) 131I-unexposed (n = 70)
Detailed classification n (%) n (%) n (%) n (%)
Fusion/SV driver 140 (100.0%) 113 (100.0%) 27 (100.0%) 69 (100.0%)
# Breaks Gain/loss at the breakpoint
2 <20 bp at both breakpoints DNA DSBs, enriched for repair by NHEJ or alt-EJ without delay in repair; no DNA fragment loss 66 (47.1%) 63 (55.8%) 3 (11.1%) 17 (24.6%)
2 <1000 bp at both breakpoints (20–999 bp at ≥1 breakpoint) DNA DSBs; unknown contribution of repair mechanisms (NHEJ, alt-EJ, SSA) with delay in repair and/or DNA fragment loss 14 (10.0%) 11 (9.7%) 3 (11.1%) 13 (18.8%)
2 ≥1000 bp loss at ≥1 breakpoint DNA DSBs; unknown contribution of repair mechanisms (NHEJ, alt-EJ, and SSA) and potential for long delay in repair and/or DNA fragment loss 4 (2.9%) 3 (2.7%) 1 (3.7%) 3 (4.3%)
≥3 <20 bp at all breakpoints DNA DSBs, enriched for repair by NHEJ or alt-EJ without delay in repair; no DNA fragment loss 1 (0.7%) 1 (0.9%) 0 1 (1.4%)
≥3 <1000 bp at all breakpoints (20–999 bp at ≥1 breakpoint) DNA DSBs; unknown contribution of repair mechanisms (NHEJ, alt-EJ, and SSA) with delay in repair and/or DNA fragment loss 7 (5.0%) 6 (5.3%) 1 (3.7%) 7 (10.1%)
≥3 ≥1000 bp loss at ≥1 breakpoint DNA DSBs; unknown contribution of repair mechanisms (NHEJ, alt-EJ, SSA) and potential for long delay in repair and/or DNA fragment loss 32 (22.9%) 20 (17.7%) 12 (44.4%) 24 (34.8%)
Other special categories
Large deletion (≥1000 bp) DNA DSBs 6 (4.3%) 3 (2.7%) 3 (11.1%) 1 (1.4%)
Large duplication (≥1000 bp; not tandem) DNA DSBs; microhomology-mediated break-induced replication 3 (2.1%) 0 3 (11.1%) 1 (1.4%)
Tandem duplication (≥1000 bp) DNA DSBs 1 (0.7%) 0 1 (3.7%) 2 (2.9%)
Templated insertion DNA DSBs; microhomology-mediated break-induced replication 3 (2.1%) 3 (2.7%) 0 0
Dicentric DNA DSBs; repaired chromosome resulted in two centromeres 2 (1.4%) 2 (1.8%) 0 0
Chromothripsis DNA DSBs 1 (0.7%) 1 (0.9%) 0 0
Mutation driver 215 (100.0%) 172 (100.0%) 43 (100.0%)
SBS 200 (93.0%) 163 (94.8%) 37 (86.0%)
Dinucleotide substitution 7 (3.3%) 5 (2.9%) 2 (4.7%)
Deletion Potentially caused by DNA DSB repair 1 (0.5%) 1 (0.6%) 0
Insertion Potentially caused by DNA DSB repair 1 (0.5%) 1 (0.6%) 0
Multiple mutations 6 (2.8%) 2 (1.8%) 4 (9.3%)

*Samples from the Chornobyl study eligible for this analysis were restricted to those with available WGS data, high tumor purity (>20%), and no evidence of tumor contamination in the normal tissue; we also excluded one tumor that did not have a known PTC driver, resulting in a total of 355 PTCs.

† Samples from the TCGA study eligible for this analysis were restricted to those with known fusion/SV drivers, available WGS data, and no known prior radiation exposure, resulting in a total of 69 PTCs.

‡ Column percent for fusion/SV and mutation drivers separately.