Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the intestinal tract. Imatinib is used asfirst-line therapy for GIST patients; however, secondary imatinib resistance poses a significant clinical challenge. Here, weanalyzed serum miRNA expression profiles to identify specific serum miRNAs that could be used as early diagnosticmarkers. Candidate miRNAs were validated using Taqman quantitative PCR with serum samples from secondary imatinibresistantGIST patients (n = 39), imatinib-sensitive GIST patients (n = 37), and healthy controls (n = 28). Serum miR-518e-5p and miR-548e levels were higher in secondary imatinib-resistant GIST than imatinib-sensitive GIST patients orhealthy controls (P\0.0001). However, ROC analysis indicated that only miR-518e-5p could distinguish imatinibresistantGIST. To discriminate imatinib-resistant from imatinib-sensitive GIST patients, the AUC for serum miR-518e-5pwas 0.9938, with 99.8% sensitivity and 82.1% specificity. Serum miR-518e-5p could also discriminate imatinib-resistantGIST patients from healthy controls with 99.9% sensitivity and 97.4% specificity. These data indicate that serum miR-518e-5p is a potentially promising non-invasive biomarker for early detection and diagnosis of secondary imatinib-resistantGIST.
Volume 45, 2020
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