Stromal signals dominate gene expression signature scores that aim to describe cancer-intrinsic stemness or mesenchymality characteristics

PurposeEpithelial-to-mesenchymal transition (EMT) in cancer cells confers migratory ability, a crucial aspect of tumor metastasis that frequently leads to death. In multiple studies, authors proposed gene expression signatures for EMT, stemness, and mesenchymality (EMT-related) characteristics of tumors based on bulk tumor expression profiling. However, recent studies have suggested that non-cancerous cells in the tumor micro- or macroenvironment heavily influence individual signature profiles. Experimental DesignWe analyzed scores of 11 published and frequently referenced gene expression signatures in bulk, single cell, and pseudo bulk expression data across multiple cancer types. ResultsOur study strengthens and extends the influence of non-cancerous cells on signatures that were proposed to describe EMT-related (EMT, mesenchymal, or stemness) characteristics in various cancer types. The cell type composition, especially the amount of tumor cells, of a tumor sample frequently dominates EMT-related signature scores. Additionally, our analyses revealed that stromal cells, most often fibroblasts, are the main drivers of the EMT-related signature scores. ConclusionsWe call attention to the risk of false conclusions about tumor properties when interpreting EMT-related signatures, especially in a clinical setting: high patient scores of EMT-related signatures or calls of "stemness subtypes" often result from low tumor cell content in tumor biopsies rather than cancer cell-specific stemness or mesenchymality/EMT characteristics.