Plasma heat shock protein 90alpha as a biomarker for the diagnosis of liver cancer: in patients with different clinicopathologic characteristics

Abstract Purposes The purposes of this study were to assess the correlation between the plasma level of Hsp90α and the clinicopathological characteristics of patients with liver cancer and compare the diagnostic efficacy of Hsp90α, AFP, CEA, and CA199 in HCC. Experimental design A total of 200 individuals, including 140 patients with liver cancer or benign liver diseases and 60 healthy people, were enrolled for quantitative measurement of plasma Hsp90α by ELISA. Results The plasma level of Hsp90α was significantly different between patients with liver cancer or benign liver diseases and healthy controls (P < 0.001). The sensitivity, specificity, and AUC (95% CI) of Hsp90α were 93.2%, 85.4%, and 0.931% (0.891–0.972%), respectively, when Hsp90α was applied to differentiate liver cancer patients and healthy controls. Significant positive correlations between the plasma Hsp90α level and clinicopathological characteristics such as the history of basic liver disease (P = 0.038), active stage of hepatitis (P = 0.039), Child-Pugh score (P < 0.001), size of focal liver lesions (P = 0.004), and extrahepatic metastasis (P < 0.001) were observed. AFP + Hsp90α was the best combination strategy for the auxiliary diagnosis of HCC, with a sensitivity of 95.7%, a specificity of 97.5%, and an AUC of 0.990 (0.976–1.000). The level of plasma Hsp90α decreased significantly (P < 0.001) after resection of tumor tissue. Conclusions This study demonstrated that plasma Hsp90α levels are useful as a diagnostic biomarker in liver cancer and may predict the responses of patients with liver cancer to surgery. Some clinicopathological characteristics could affect the plasma Hsp90α levels.

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A Circulating Long Noncoding RNA Panel Serves as a Diagnostic Marker for Hepatocellular Carcinoma

Disease Markers ◽

10.1155/2020/5417598 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Jinlan Huang ◽

Yansong Zheng ◽

Xialin Xiao ◽

Can Liu ◽

Jinpiao Lin ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Logistic Regression ◽

Noncoding Rna ◽

Predictive Ability ◽

High Sensitivity ◽

Clinicopathological Characteristics ◽

Healthy Controls ◽

Diagnostic Efficacy ◽

Noninvasive Biomarker ◽

Positive Correlations

Background. Circulating long noncoding RNAs (lncRNAs) have been demonstrated to serve as diagnostic biomarkers for various cancers. We aimed to elucidate the diagnostic efficacy of eight serum lncRNAs HULC, MALAT1, Linc00152, PTENP1, PTTG3P, SPRY4-IT1, UBE2CP3, and UCA1 and their combinations for the diagnosis of hepatocellular carcinoma (HCC). Methods. A total of 129 patients with HCC, 49 patients with liver cirrhosis, 27 patients with chronic hepatitis B, and 93 healthy controls were enrolled in this study. The levels of serum lncRNAs were assessed by quantitative real-time polymerase chain reaction. The correlations between serum lncRNAs and clinicopathological characteristics were further analyzed. The receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to estimate the diagnostic capacity of serum lncRNAs and their combination with AFP for HCC. A logistic regression model was performed to establish a multiple-lncRNA panel. Results. The levels of serum HULC, MALAT1, Linc00152, PTTG3P, SPRY4-IT1, UBE2CP3, and UCA1 were significantly higher in HCC patients than in patients with benign liver diseases and healthy controls, whereas serum PTENP1 was significantly decreased in HCC patients compared with healthy participants. Positive correlations between serum Linc00152 and GGT, serum PTTG3P and GGT, and serum SPRY4-IT1 and ALT were noted in HCC patients. ROC analysis revealed that all these lncRNAs had a significantly predictive value for HCC except for PTENP1. The best performance of single lncRNA was obtained by Linc00152 with an AUC of 0.877. When combined with AFP, the combination of Linc00152 and AFP gained the highest accuracy, yielding an AUC of 0.906. Through logistic regression analysis, the panel consisting of serum linc00152, UCA1, and AFP provided the greatest predictive ability, obtaining an AUC of 0.912 with 82.9% sensitivity and 88.2% specificity. Conclusion. The panel of serum Linc00152, UCA1, and AFP demonstrates a novel and noninvasive biomarker with relatively high sensitivity and specificity for HCC diagnosis.

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Serum Long Non-Coding RNA SCARNA10 Serves As A Potential Diagnostic Biomarker For Hepatocellular Carcinoma

10.21203/rs.3.rs-757014/v2 ◽

2021 ◽

Author(s):

Yawei Han ◽

Wenna Jiang ◽

Yu Wang ◽

Meng Zhao ◽

Yueguo Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

High Sensitivity ◽

Tumor Stage ◽

Clinicopathological Characteristics ◽

Healthy Controls ◽

Diagnostic Efficacy ◽

Non Invasive ◽

Non Coding Rna ◽

Diagnostic Capacity ◽

Positive Correlations

Abstract Background: Circulating long non-coding RNAs (lncRNAs) have been demonstrated to serve as diagnostic or prognosis biomarkers for various disease. We aimed to elucidate the diagnostic efficacy of serum lncRNA SCARNA10 for the hepatocellular carcinoma (HCC).Methods: In this study, a total of 127 patients with HCC, 55 patients with benign liver disease (BLD), and 99 healthy controls (HC) were enrolled in this study. According to different classifications, the levels of serum SCARNA10 were assessed by quantitative real-time polymerase chain reaction (qPCR). The correlations between serum SCARNA10 and clinicopathological charcaterisstics were further analyzed. The receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to estimate the diagnostic capacity of serum SCARNA10 and its combination with AFP for HCC. Results: The results demonstrated that the levels of serum SCARNA10 were significantly higher in HCC patients than in patients with BLD and healthy controls, and significantly increased in HCC patients with hepatitis B or C infection, or with liver cirrhosis. Furthermore, positive correlations were noted between serum SCARNA10 level and some clinicopathological characteristics, including tumor size, differentiation degrees, tumor stage, vascular invasion, tumor metastasis and complications. ROC analysis revealed that SCARNA10 had a significantly predictive value for HCC, the combination of SCARNA10 and AFP gained the higher accuracy. SCARNA10 retained significant diagnosis capabilities for AFP-negative HCC patients. Conclusions: In summary, lncRNA SCARNA10 may serve as a novel and non-invasive biomarker with relatively high sensitivity and specificity for HCC diagnosis.

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Prognostic Value of the Glycoprotein TAG-72 in Patients with Gastric Cancer

The International Journal of Biological Markers ◽

10.1177/172460080101600206 ◽

2001 ◽

Vol 16 (2) ◽

pp. 121-125 ◽

Cited By ~ 5

Author(s):

A.M. González Vitores ◽

G. Encabo Duró ◽

B. Bermejo Fraile ◽

M. Armengol Carrasco

Keyword(s):

Gastric Cancer ◽

Liver Diseases ◽

Prognostic Value ◽

Gastrointestinal Diseases ◽

Disease Monitoring ◽

Healthy Controls ◽

Benign Diseases ◽

Prognostic Assessment ◽

Benign Liver ◽

Disease Free

The specificity of the tumor markers used to date in patients with gastric cancer has not been satisfactory. For this reason we decided to evaluate the utility of TAG-72 in this disease. Between 1993 and 1998 we determined the levels of TAG-72 in 638 subjects (148 healthy volunteers, 33 patients with chronic renal failure (CRF), 149 patients with benign diseases of the liver, 95 patients with benign gastrointestinal diseases and 213 patients with gastric cancer). TAG-72 was measured using an IRMA method. Statistical analysis of the data was performed with the BMDP package. We established a cutoff for TAG-72 of 3 U/mL, corresponding to the 92.6th percentile of the healthy controls. We observed that neither CRF nor benign liver diseases affected TAG-72 levels, while certain benign gastrointestinal diseases did cause alterations of the marker. Using Cox multivariate analysis we discovered that the preoperative TAG-72 level was an independent prognostic variable associated with both disease-free and overall survival. We conclude that, although TAG-72 is not useful for the diagnosis of gastric cancer, it is a suitable tool for disease monitoring and prognostic assessment.

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Serum Long Non-Coding RNA SCARNA10 Serves as a Potential Diagnostic Biomarker for Hepatocellular Carcinoma

10.21203/rs.3.rs-757014/v1 ◽

2021 ◽

Author(s):

Yawei Han ◽

Wenna Jiang ◽

Yu Wang ◽

Meng Zhao ◽

Yueguo Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

High Sensitivity ◽

Tumor Stage ◽

Clinicopathological Characteristics ◽

Healthy Controls ◽

Diagnostic Efficacy ◽

Non Invasive ◽

Non Coding Rna ◽

Diagnostic Capacity ◽

Positive Correlations

Abstract Circulating long non-coding RNAs (lncRNAs) have been demonstrated to serve as diagnostic or prognosis biomarkers for various disease. We aimed to elucidate the diagnostic efficacy of serum lncRNA SCARNA10 for the hepatocellular carcinoma (HCC). A total of 127 patients with HCC, 55 patients with benign liver disease (BLD), and 99 healthy controls (HC) were enrolled in this study. According to different classifications, the levels of serum SCARNA10 were assessed by quantitative real-time polymerase chain reaction (qPCR). The correlations between serum SCARNA10 and clinicopathological charcaterisstics were further analyzed. The receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to estimate the diagnostic capacity of serum SCARNA10 and its combination with AFP for HCC. The results demonstrated that the levels of serum SCARNA10 were significantly higher in HCC patients than in patients with BLD and healthy controls, and significantly increased in HCC patients with hepatitis B or C infection, or with liver cirrhosis. Furthermore, positive correlations were noted between serum SCARNA10 level and some clinicopathological characteristics, including tumor size, differentiation degrees, tumor stage, vascular invasion, tumor metastasis and complications. ROC analysis revealed that SCARNA10 had a significantly predictive value for HCC, the combination of SCARNA10 and AFP gained the higher accuracy. SCARNA10 retained significant diagnosis capabilities for AFP-negative HCC patients. In summary, lncRNA SCARNA10 may serve as a novel and non-invasive biomarker with relatively high sensitivity and specificity for HCC diagnosis.

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PIVKA-II serves as a potential biomarker that complements AFP for the diagnosis of hepatocellular carcinoma

BMC Cancer ◽

10.1186/s12885-021-08138-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Honglei Feng ◽

Bole Li ◽

Ze Li ◽

Qian Wei ◽

Li Ren

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Malignant Tumors ◽

Characteristic Curve ◽

Clinicopathological Characteristics ◽

High Morbidity ◽

Healthy Controls ◽

Diagnostic Efficiency ◽

Potential Biomarker ◽

Benign Liver

Abstract Background Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system and has high morbidity and mortality rates. It is essential to search new biomarkers to improve the accuracy of early HCC diagnosis. Therefore, we evaluated the diagnostic value of prothrombin induced by vitamin K deficiency or antagonist- II (PIVKA-II) as a potential biomarker that complements α-fetoprotein (AFP) in HCC by detecting the serum PIVKA-II levels. Methods Serum PIVKA-II levels were compared in 168 HCC patients, 150 benign liver disease patients and 153 healthy controls to investigate the PIVKA-II potential to be a HCC biomarker. Receiver operating characteristic curve (ROC) analysis was used to evaluate the value of PIVKA-II in the diagnosis of HCC and its complementary role of AFP. The correlation between serum PIVKA-II levels and clinicopathological characteristics was analyzed to study the value of PIVKA-II in assessing HCC progression and prognosis. Finally, the ability of PIVKA-II in assessing the surgical treatment effects of HCC was studied by comparing the pre- and post-operative serum PIVKA-II levels in 89 HCC patients. Results Serum PIVKA-II levels in HCC patients were significantly higher than that in patients with benign liver disease and healthy controls. The PIVKA-II performance in the diagnosing HCC as an individual biomarker was remarkable. The combined detection of PIVKA-II and AFP improved the diagnostic efficiency of HCC. PIVKA-II retained significant diagnosis capabilities for AFP-negative HCC patients. Significant correlations were found between PIVKA-II expression levels and some clinicopathological characteristics, including tumor size, tumor stage, tumor metastasis, differentiation degree and complications. PIVKA-II expression obviously decreased after surgical resection. Conclusions PIVKA-II is a promising serum biomarker for the HCC diagnosis that can be used as a supplement for AFP. The combined diagnosis of the two markers greatly improved the diagnostic efficiency of HCC. The PIVKA-II levels in HCC patients were widely associated with clinicopathological characteristics representing tumor cell dissemination and/or poor prognosis. PIVKA-II can be used to evaluate the curative effects of HCC resection.

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Assessment of miR-212 and Other Biomarkers in the Diagnosis and Treatment of HBV-infection-related Liver Diseases

Current Drug Metabolism ◽

10.2174/1389200220666191011120434 ◽

2019 ◽

Vol 20 (10) ◽

pp. 785-798 ◽

Cited By ~ 1

Author(s):

Yigan Zhang ◽

Huaze Xi ◽

Xin Nie ◽

Peng Zhang ◽

Ning Lan ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Liver Cancer ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Liver Diseases ◽

Meld Score ◽

Hbv Infection ◽

Expression Level ◽

Control Group

Objective: Our study aims to detect the sensitivity of the new biomarker miR-212 existing in serum exosomes along with other hepatocellular carcinoma biomarkers such as AFP (alpha-fetoprotein), CA125 (carbohydrate antigen-ca125), and Hbx protein in the diagnosis of HBV-related liver diseases. We also aim to study the roles of these biomarkers in the progression of chronic hepatitis B and provide scientific data to show the clinical value of these biomarkers. Methods: We selected 200 patients with HBV-infection (58 cases of chronic hepatitis B, 47 cases of hepatocellular carcinoma, 30 cases of compensatory phase cirrhosis, and 65 cases of decompensatory phase cirrhosis), 31 patients with primary liver cancer without HBV infection, and 70 healthy individuals as the control group. The expression level of serum AFP and CA125 was detected with electrochemiluminescence immunoassay. The expression level of the Hbx protein was detected with ELISA. Meanwhile, the expression level of miR-212 in serum was analyzed with RT-qPCR. We collected patients’ clinical information following the Child-Pugh classification and MELD score criterion, and statistical analysis was made between the expression level of miR-212 and the collected clinical indexes. Lastly, we predicted the target genes of the miR-212 and its functions using bioinformatics methods such as cluster analysis and survival prediction. Results: Compared to the control group, the expression level of miR-212 in HBV infected patients was remarkably increased (P<0.05), especially between the HBV-infection Hepatocellular carcinoma group and the non-HBVinfection liver cancer group (P<0.05). The expression of miR-212 was increased in patients’ Child-Pugh classification, MELD score, and TNM staging. Moreover, the sensitivity and specificity of miR-212 were superior to AFP, CA125, and HBx protein. Conclusion: There is a linear relationship between disease progression and expression level of miR-212 in the serum of HBV infected patients. This demonstrates that miR-212 plays a significant role in liver diseases. miR-212 is expected to be a new biomarker used for the diagnosis and assessment of patients with HBV-infection-related liver diseases.

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Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions

Diagnostics ◽

10.3390/diagnostics11071244 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1244

Author(s):

Sonja Schwarz ◽

Dirk-André Clevert ◽

Michael Ingrisch ◽

Thomas Geyer ◽

Vincent Schwarze ◽

...

Keyword(s):

Logistic Regression ◽

Diagnostic Accuracy ◽

Late Phase ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Malignant Lesions ◽

Benign Liver ◽

Benign Liver Lesions

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.

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The Course of AαVal541 as a Proteinase 3 Specific Neo-Epitope after Alpha-1-Antitrypsin Augmentation in Severe Deficient Patients

International Journal of Molecular Sciences ◽

10.3390/ijms22158031 ◽

2021 ◽

Vol 22 (15) ◽

pp. 8031

Author(s):

Iris G. M. Schouten ◽

Richard A. Mumford ◽

Dirk Jan A. R. Moes ◽

Pieter S. Hiemstra ◽

Jan Stolk

Keyword(s):

Plasma Level ◽

Serine Proteases ◽

Population Pharmacokinetic ◽

Proteinase 3 ◽

Healthy Controls ◽

Population Pharmacokinetic Modeling ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin

In alpha-1-antitrypsin deficiency (AATD), neutrophil serine proteases such as elastase and proteinase 3 (PR3) are insufficiently inhibited. A previous study in AATD patients showed a higher plasma level of the specific PR3-generated fibrinogen-derived peptide AαVal541, compared with healthy controls. Here, we analyzed the course of AαVal541 plasma levels during 4 weeks after a single iv dose of 240 mg/kg AAT in ten patients with genotype Z/Rare or Rare/Rare. To this end, we developed an immunoassay to measure AαVal541 in plasma and applied population pharmacokinetic modeling for AAT. The median AαVal541 plasma level before treatment was 140.2 nM (IQR 51.5–234.8 nM)). In five patients who received AAT for the first time, AαVal541 levels decreased to 20.6 nM (IQR 5.8–88.9 nM), and in five patients who already had received multiple infusions before, it decreased to 26.2 nM (IQR 22.31–35.0 nM). In 9 of 10 patients, AαVal541 levels were reduced to the median level of healthy controls (21.4 nM; IQR 16.7–30.1 nM). At 7–14 days after treatment, AαVal541 levels started to increase again in all patients. Our results show that fibrinopeptide AαVal541 may serve as a biochemical footprint to assess the efficacy of in vivo inhibition of PR3 activity in patients receiving intravenous AAT augmentation therapy.

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AB1104 ANALYSIS OF ANTINUCLEAR ANTIBODY TITERS AND PATTERNS USING HEP 2 INDIRECT IMMUNOFLUORESCENCE IN VARIOUS LIVER DISEASES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.726 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1841-1842

Author(s):

Q. Wei ◽

Y. Jiang ◽

M. Yang ◽

J. Xie ◽

M. Xiao ◽

...

Keyword(s):

Virus Infection ◽

Liver Diseases ◽

Antinuclear Antibody ◽

Biliary Cirrhosis ◽

Hepatitis B Virus Infection ◽

Healthy Controls ◽

Hepatitis C Virus Infection ◽

Hepatic Carcinoma ◽

Autoimmune Rheumatic Diseases ◽

B Virus

Background:Abnormal liver function can be seen in not only hepatitis B virus infection (HBV), hepatitis C virus infection (HCV), hepatic carcinoma (HCC), but also in primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and systemic autoimmune rheumatic diseases (SARD). Antinuclear antibody (ANA) testing using indirect immunofluorescence assay (IIFA) is a common and economical method which contributes to detect SARD and autoimmune liver diseases [1].Objectives:Our objective was to investigate ANA positivity, titers and their patterns in multiple liver diseases, including PBC, AIH, HBV, HCV, and HCC, compared to healthy controls (HC).Methods:2537 patients with SARD, 137 PBC cases, 57 AIH cases, 3420 HBV cases, 769 HCV cases, 268 HCC cases, and 1073 HC were retrospectively assessed. The titers and patterns of ANA were detected with the IIFA method.Results:ANA positivity rate was considerably discernible between these diseases, which is 90.1% in SARD, 93.4% in PBC, 49.1% in AIH, 19.1% in HBV, 13.9% in HCV and 23.5% in HCC. Moreover, only 4.9% of HCC cases, 2.5% of HBV patients and 1.6% of HCV patients had an ANA titer ≥ 1:320. The mixed pattern which composed of at least two patterns majorly lied in PBC. AC-15 and AC-21 was frequently related to liver diseases; the former pattern was more frequently found in AIH (84.2%) and PBC (8.8%), and the latter pattern was easily seen in PBC (62.2%) and HCC (22.6%). The positive rate of ANA in HC was 12.2% and its major pattern was AC-2.Conclusion:There are differences in ANA positivity among patients with SARD and various liver diseases. Some mixed patterns may provide important evidence for the diagnosis of PBC. Clinicians should pay attention to ANA patterns and titer during the interpretation of this test.References:[1]Damoiseaux J, Andrade L, Carballo OG, Conrad K, Francescantonio P, Fritzler MJ, Garcia DLTI, Herold M, Klotz W, Cruvinel WM, Mimori T, von Muhlen C, Satoh M, Chan EK, (2019) Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. ANN RHEUM DIS 78: 879-889Figure 1.The Proportion of Each ANA Pattern Exhibited in Different Diseases and HCANA: antinuclear antibodies; HC: healthy controls; PBC: primary biliary cirrhosis; AIH: autoimmune hepatitis; SARD: systemic autoimmune rheumatic diseases; HBV: hepatitis B virus infection: HCV: hepatitis C virus infection: HCC: hepatic carcinoma.Acknowledgments:None.Disclosure of Interests:None declared

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Long-term Survival among Patients with Gastrointestinal Stromal Tumors Diagnosed after Another Malignancy: A SEER Population-Based Study

10.21203/rs.2.21309/v1 ◽

2020 ◽

Author(s):

Chaoyong Shen ◽

Chengshi Wang ◽

Tao He ◽

Zhaolun Cai ◽

Xiaonan Yin ◽

...

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Population Based ◽

Clinicopathological Characteristics ◽

Second Primary ◽

Primary Malignancy ◽

Clinicopathologic Characteristics ◽

Term Survival ◽

Stromal Tumors ◽

Group A

Abstract BACKGROUND: To explore overall survival (OS) and GISTs-specific survival (GSS) among cancer survivors developing a second primary gastrointestinal stromal tumors (GISTs). METHODS: We conducted a cohort study, where patients with GISTs after another malignancy (AM-GISTs, n=851) and those with only GISTs (GISTs-1, n=7660) were identified from the Surveillance, Epidemiology, End Results registries (1988-2016). Clinicopathologic characteristics and survival were compared between the two groups. RESULTS: The most commonly diagnosed first primary malignancy was prostate cancer (27.7%), followed by breast cancer (16.2%). OS among AM-GISTs was significantly inferior to that of GISTs-1: 10-year OS was 40.3% vs. 50.0%, (p<0.001); A contrary finding was observed for GSS (10-year GSS: 68.9% vs. 61.8%, p=0.002). In the AM-GISTs group, a total of 338 patients died, of which 26.0% died of their initial cancer and 40.8% died of GISTs. Independent of demographics and clinicopathological characteristics, mortality from GISTs among AM-GISTs patients was decreased compared with their GISTs-1 counterparts (HR, 0.71; 95% CI, 0.59-0.84; p<0.001); whereas OS was inferior among AM-GISTs (HR, 1.11; 95% CI, 0.99-1.25; p=0.085). CONCLUSIONS: AM-GISTs patients have decreased risk of dying from GISTs compared with GIST-1. Although another malignancy history does not seemingly affect OS for GISTs patients, clinical treatment of such patients should be cautious.

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