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Updated: Aug 5, 2026
Spatial Profiling of Protein and RNA Expression in Tissue: An Approach to Fine-Tune Virtual Microdissection
Published on: July 6, 2022
Spatial proteomics deciphers the immune niche landscape of non-ampullary duodenal adenocarcinoma
Yuichiro Kohara1, Satoshi Yasuda1, Tomoko Uchiyama2
1Department of Surgery, Nara Medical University, Nara, Japan.
Background:
Non-ampullary duodenal adenocarcinoma (NADA) is a rare malignancy with an incompletely characterised tumour immune microenvironment (TME). We aimed to elucidate its immune niche landscape and validate a clinically applicable transcriptomic surrogate.
Methods:
In 38 resected NADA cases, multiplex immunofluorescence spatial proteomics was performed on tissue microarrays, validated by cohort-wide whole-slide imaging. A 10-gene qRT-PCR panel capturing adaptive immune resistance mechanisms was integrated with spatial data. Molecular microsatellite instability (MSI) testing confirmed mismatch repair (MMR) status in all integrated cases.
Results:
Spatial proteomics identified seven distinct cellular niches; the immune-active "Hot spot" niche showed a trend toward prolonged survival. The 10-gene panel classified patients into "Hot," "Intermediate," and "Cold" clusters, with the "Hot" cluster significantly enriched in "Hot spot." A pMMR subgroup with abundant "Hot spot" (7/29, 24.1%) was identified, most belonging to the "Hot" cluster (5/7, 71.4%). Molecular MSI testing confirmed all pMMR "Hot" cases as microsatellite stable. External transcriptomic analysis revealed enrichment of interferon-gamma and inflammatory response pathways in the "Hot" group.
Conclusion:
Spatial proteomics identified an immune-active "Hot spot" niche in NADA. The 10-gene panel serves as a spatial surrogate, identifying a microsatellite-stable pMMR subgroup that may represent a biologically relevant subgroup for future investigation.
