Formalin-fixed paraffin embedded (FFPE) tissues are widely used in pathological diagnostics.
Although DNA extracted from FFPE samples is suitable for massively parallel sequencing, building
sequencing libraries from multiple FFPE samples remains technically challenging and costly. Here,
we present a method, CUTseq, that allows multiplexed genome barcoding, amplification and
reduced representation sequencing of DNA extracted from individual FFPE tissue sections or
multiple sub-regions in them. CUTseq uses restriction enzymes to fragment and barcode the
genome at defined locations, and the T7 phage promoter to amplify the DNA sequence surrounding
the cut sites before a sequencing library is prepared. We compared CUTseq with a standard way for
preparing sequencing libraries compatible with Illumina technology using DNA extracted from
FFPE sections of different tumor types, demonstrating a strong correlation between DNA copy
number profiles obtained with two approaches. Furthermore, by applying CUTseq to DNA
extracted from dozens of small (<10 mm 2 ) regions inside individual FFPE tissue sections of primary
breast cancers and matched metastases, we were able to study intra-tumor heterogeneity in DNA
copy number, at a spatial resolution so far unattained. CUTseq is a versatile and cost-effective
method for multiplexed reduced representation genome sequencing that can be applied to both fixed
and non-fixed samples. Less...