Lee-Six · Nature 2019 · Cross-sectional tissue genomic study · n=42

The landscape of somatic mutation in normal colorectal epithelial cells.

Level 4 - case-series / case-control

Cross-sectional genomic profiling of human tissue specimens (graded by design analogy).

PubMed 31645730 · doi:10.1038/s41586-019-1672-7 · record verified 2026-08-26

What was done

Whole-genome sequencing was performed on hundreds of individual normal colorectal crypts sampled from 42 individuals to characterize somatic mutations and mutational signatures in morphologically normal colorectal epithelium.

What was found

Signatures of multiple mutational processes were identified, including both ubiquitous/continuous processes and others restricted to specific individuals, crypts, or life periods. Probable driver mutations were identified in approximately 1% of normal colorectal crypts from middle-aged individuals. Colorectal cancers demonstrated substantially higher mutational burdens than normal cells, though specific numerical counts for mutational burdens were not reported in the abstract.

Why it matters

This study demonstrates that neoplastic somatic mutations and early clonal expansions are common in morphologically normal tissue, showing that adenomas and carcinomas represent rare endpoints of a widespread background evolutionary process.

Limits

The sample size is relatively small (42 individuals). The abstract does not provide exact total crypt counts, specific driver mutation types, or absolute mutational burden values, and the cross-sectional design cannot directly track the prospective neoplastic potential of mutated crypts.

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