Fig. 3: “Lymphatic” and “hematogenous” evolution pattern of NPC metastases indicated from genome sequencing data.

a Schematic diagram illustrating the classification of distant metastases into lymphatic or hematogenous evolution patterns. b Bootstrap values reflecting the evolutionary pattern confidence for each distant metastasis in 15 patients with matched primary, regional lymph node metastasis and distant metastasis samples before treatment. Samples with both probabilities less than 75% (P05Met, P06Met), as indicated by the dashed lines, were too ambiguous for classification and were removed in downstream analysis. c, d Typical examples of lymphatic (c) and hematogenous (d) models. Left: Phylogenetic tree with bootstrap values for each divergence node. Right: Subclone-based evolution analysis revealed the same pattern as the phylogenetic tree. Each colour of the bell plot represents a specific subclone. For the lymphatic pattern, one or more subclones found in the distant metastasis could also be found in the regional lymph node metastasis instead of the primary tumour. Otherwise, this kind of cluster is not found in the hematogenous evolution pattern. The CCF value of each subclone in each sample at the time of sampling is marked in the bell plot. e–g Distant metastases show consistent evolutionary patterns revealed by patients with multiregion or multiorgan distant metastases. All distant metastases from P07 and P14 are classified as the lymphatic route (e, f), and all distant metastases from P15 are classified as the hematogenous route (g). Source data are provided as a Source Data file.