The Prognostic Value of Plasma Small Extracellular Vesicles' Phenotype in Patients With Gastrointestinal Stromal Tumor

Charlotte M Brinch*, Estrid Hogdall, Pieter DE Heer, Luit Penninga, Rikke Bæk, Malene M Jorgensen, Bodil E Engelmann, Philip B Rossen, Helene J Mortensen, Anders Krarup-Hansen, Ninna Aggerholm-Pedersen

*Corresponding author for this work


BACKGROUND/AIM: For patients with local gastrointestinal stromal tumor (GIST), risk stratification is used to assess the prognosis and identify patients to offer adjuvant treatment. For patients with advanced or metastatic GIST, no such risk stratification exists. This study aimed to investigate the prognostic value of 31 different plasma small extracellular vesicles' (SEVs) surface proteins in GIST patients.

MATERIALS AND METHODS: GIST patients from the two sarcoma centers in Denmark were included. Patients were divided into three groups; group 1: patients undergoing radical surgery; group 2: patients with local, locally advanced, or metastatic GIST; and group 3: patients without evidence of disease after radical surgery. Protein microarray technology was used for the analysis of plasma SEVs. The median plasma SEV marker level was used when comparing groups of patients. The primary endpoint was the progression of GIST. Iterative statistical modeling was used to identify a SEV marker profile/model with a prognostic value.

RESULTS: A total of 157 patients were included, with a median follow-up time of 2.05 years. In group 2, a high level of carcinoembryonic antigen (CEA) and a low level of glucose transporter 1 (GLUT-1) were found to be poor prognostic factors [univariate analysis; GLUT-1: hazard ratio (HR)=0.47, 95% confidence interval (CI)=0.22-0.98; CEA: HR=2.12, 95%CI=1.02-4.44]. Composing a model consisting of CEA and GLUT-1 adjusted for age at inclusion was found to have a prognostic value (HR=4.93, 95%CI=2.30-10.57, p<0.0001).

CONCLUSION: Plasma SEVs in GIST showed that CEA and GLUT-1 might be of prognostic value. However, external validation is needed.

Original languageEnglish
JournalAnticancer Research
Issue number12
Pages (from-to)5699-5717
Number of pages19
Publication statusPublished - Dec 2022


  • Humans
  • Prognosis
  • Gastrointestinal Stromal Tumors
  • Carcinoembryonic Antigen
  • Extracellular Vesicles
  • Phenotype
  • Neoplasms, Second Primary


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