Background

Small cell lung cancer (SCLC) is the most aggressive subtype of lung cancer without recognised morphologic or genetic heterogeneity. Based on the expression of four transcription factors, ASCL1, NEUROD1, POU2F3, and YAP1, SCLCs are classified into four subtypes. However, biological functions of these different subtypes are largely uncharacterised.

Methods

We studied intratumoural heterogeneity of resected human primary SCLC tissues using single-cell RNA-Seq. In addition, we undertook a series of in vitro and in vivo functional studies to reveal the distinct features of SCLC subtypes.

Results

We identify the coexistence of ASCL1⁺ and NEUROD1⁺ SCLC cells within the same human primary SCLC tissue. Compared with ASCL1⁺ SCLC cells, NEUROD1⁺ SCLC cells show reduced epithelial features and lack EPCAM expression. Thus, EPCAM can be considered as a cell surface marker to distinguish ASCL1⁺ SCLC cells from NEUROD1⁺ SCLC cells. We further demonstrate that NEUROD1⁺ SCLC cells exhibit higher metastatic capability than ASCL1⁺ SCLC cells and can be derived from ASCL1⁺ SCLC cells.

Conclusions

Our studies unveil the biology and evolutionary trajectory of ASCL1⁺ and NEUROD1⁺ SCLC cells, shedding light on SCLC tumourigenesis and progression.