Martincorena · Science (New York, N.Y.) 2018 · cross-sectional genomic mapping study · n=9 donors

Somatic mutant clones colonize the human esophagus with age.

Cited 1179 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional post-mortem/donor tissue genomic analysis (n = 9).

PubMed 30337457 · doi:10.1126/science.aau3879 · record verified 2026-08-30

What was done

Genome sequencing was performed on normal esophageal epithelium samples collected from 9 human donors aged 20 to 75 years to map the accumulation and clonal expansion of somatic mutations across the lifespan.

What was found

Somatic mutations accumulated with age, predominantly via intrinsic mutational processes. There was strong positive selection for clones carrying mutations in 14 cancer genes, reaching tens to hundreds of clones per square centimeter. In middle-aged and elderly donors, clones carrying cancer-associated mutations covered much of the epithelium: NOTCH1 mutations affected 12% to 80% of cells, and TP53 mutations affected 2% to 37% of cells. The prevalence of NOTCH1 mutations in normal tissue was several times higher than in esophageal cancers.

Why it matters

This study shows that normal aging human esophagus is heavily colonized by clones bearing classic oncogenic mutations, shifting understanding of the baseline genomic landscape of healthy aging tissue.

Limits

The sample size is very small (n = 9 donors), limiting demographic and risk factor stratification. The abstract does not detail donor medical histories or exposures, nor does it provide longitudinal follow-up on cancer progression.

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