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However, the study of phenotypic plasticity is hindered by the rarity of these events within primary lesions and by the lack of experimental models. Here, we identified a subpopulation of phenotypic plastic colon cancer cells: EpCAM\n                    <jats:sup>lo<\/jats:sup>\n                    cells are motile, invasive, chemo-resistant, and highly metastatic. EpCAM\n                    <jats:sup>lo<\/jats:sup>\n                    bulk and single-cell RNAseq analysis indicated (1) enhanced Wnt\/\u03b2-catenin signaling, (2) a broad spectrum of degrees of epithelial to mesenchymal transition (EMT) activation including hybrid E\/M states (partial EMT) with highly plastic features, and (3) high correlation with the CMS4 subtype, accounting for colon cancer cases with poor prognosis and a pronounced stromal component. Of note, a signature of genes specifically expressed in EpCAM\n                    <jats:sup>lo<\/jats:sup>\n                    cancer cells is highly predictive of overall survival in tumors other than CMS4, thus highlighting the relevance of quasi-mesenchymal tumor cells across the spectrum of colon cancers. Enhanced Wnt and the downstream EMT activation represent key events in eliciting phenotypic plasticity along the invasive front of primary colon carcinomas. Distinct sets of epithelial and mesenchymal genes define transcriptional trajectories through which state transitions arise. pEMT cells, often earmarked by the extracellular matrix glycoprotein SPARC together with nuclear ZEB1 and \u03b2-catenin along the invasive front of primary colon carcinomas, are predicted to represent the origin of these (de)differentiation routes through biologically distinct cellular states and to underlie the phenotypic plasticity of colon cancer cells.\n                  <\/jats:p>","DOI":"10.7554\/elife.61461","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T08:01:33Z","timestamp":1622016093000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.61461","source":"Crossref","is-referenced-by-count":67,"title":["Phenotypic plasticity underlies local invasion and distant metastasis in colon cancer"],"prefix":"10.7554","volume":"10","author":[{"given":"Andrea","family":"Sacchetti","sequence":"first","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Teeuwssen","sequence":"first","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-8379","authenticated-orcid":true,"given":"Mathijs","family":"Verhagen","sequence":"first","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalie","family":"Joosten","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Stabile","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berdine","family":"van der Steen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alem","family":"Gusinac","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erasmus MC","place":["Rotterdam, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Kyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Natural Product Research Center, Korea Institute of Science and Technology","place":["Gangneung, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Ubink","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Cancer Centre, University Medical Centre Utrecht","place":["Utrecht, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9794-1477","authenticated-orcid":true,"given":"Harmen JG","family":"Van de Werken","sequence":"additional","affiliation":[{"name":"Cancer Computational Biology Center and Department of Urology; 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