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Published in: BMC Medical Informatics and Decision Making 1/2023

Open Access 01-12-2023 | Gastrointestinal Stromal Tumor | Research

Intelligent identification system of gastric stromal tumors based on blood biopsy indicators

Authors: Shangjun Han, Meijuan Song, Jiarui Wang, Yalong Huang, Zuxi Li, Aijia Yang, Changsheng Sui, Zeping Zhang, Jiling Qiao, Jing Yang

Published in: BMC Medical Informatics and Decision Making | Issue 1/2023

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Abstract

Background

The most prevalent mesenchymal-derived gastrointestinal cancers are gastric stromal tumors (GSTs), which have the highest incidence (60–70%) of all gastrointestinal stromal tumors (GISTs). However, simple and effective diagnostic and screening methods for GST remain a great challenge at home and abroad. This study aimed to build a GST early warning system based on a combination of machine learning algorithms and routine blood, biochemical and tumour marker indicators.

Methods

In total, 697 complete samples were collected from four hospitals in Gansu Province, including 42 blood indicators from 318 pretreatment GST patients, 180 samples of gastric polyps and 199 healthy individuals. In this study, three algorithms, gradient boosting machine (GBM), random forest (RF), and logistic regression (LR), were chosen to build GST prediction models for comparison. The performance and stability of the models were evaluated using two different validation techniques: 5-fold cross-validation and external validation. The DeLong test assesses significant differences in AUC values by comparing different ROC curves, the variance and covariance of the AUC value.

Results

The AUC values of both the GBM and RF models were higher than those of the LR model, and this difference was statistically significant (P < 0.05). The GBM model was considered to be the optimal model, as a larger area was enclosed by the ROC curve, and the axes indicated robust model classification performance according to the accepted model discriminant. Finally, the integration of 8 top-ranked blood indices was proven to be able to distinguish GST from gastric polyps and healthy people with sensitivity, specificity and area under the curve of 0.941, 0.807 and 0.951 for the cross-validation set, respectively.

Conclusion

The GBM demonstrated powerful classification performance and was able to rapidly distinguish GST patients from gastric polyps and healthy individuals. This identification system not only provides an innovative strategy for the diagnosis of GST but also enables the exploration of hidden associations between blood parameters and GST for subsequent studies on the prevention and disease surveillance management of GST. The GST discrimination system is available online for free testing of doctors and high-risk groups at https://​jzlyc.​gsyy.​cn/​bear/​mobile/​index.​html.
Literature
1.
go back to reference Schaefer IM, DeMatteo RP, Serrano C. The GIST of Advances in Treatment of Advanced Gastrointestinal Stromal Tumor. American Society of Clinical Oncology educational book American Society of Clinical Oncology Annual Meeting. 2022;42:1–15. Schaefer IM, DeMatteo RP, Serrano C. The GIST of Advances in Treatment of Advanced Gastrointestinal Stromal Tumor. American Society of Clinical Oncology educational book American Society of Clinical Oncology Annual Meeting. 2022;42:1–15.
2.
go back to reference Blay JY, Kang YK, Nishida T, von Mehren M. Gastrointestinal stromal tumours. Nat Rev Dis Primers. 2021;7(1):22.CrossRefPubMed Blay JY, Kang YK, Nishida T, von Mehren M. Gastrointestinal stromal tumours. Nat Rev Dis Primers. 2021;7(1):22.CrossRefPubMed
3.
go back to reference Mantese G. Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment. Curr Opin Gastroenterol. 2019;35(6):555–9.CrossRefPubMed Mantese G. Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment. Curr Opin Gastroenterol. 2019;35(6):555–9.CrossRefPubMed
4.
go back to reference Al-Share B, Alloghbi A, Al Hallak MN, Uddin H, Azmi A, Mohammad RM, et al. Gastrointestinal stromal tumor: a review of current and emerging therapies. Cancer Metastasis Rev. 2021;40(2):625–41.CrossRefPubMed Al-Share B, Alloghbi A, Al Hallak MN, Uddin H, Azmi A, Mohammad RM, et al. Gastrointestinal stromal tumor: a review of current and emerging therapies. Cancer Metastasis Rev. 2021;40(2):625–41.CrossRefPubMed
5.
go back to reference Sunamak O, Gul MO, Subasi IE, Donmez T, Ozkara S. Gastrointestinal stromal tumours. J Coll Physicians Surg Pak. 2021;31(9):1089–93.CrossRefPubMed Sunamak O, Gul MO, Subasi IE, Donmez T, Ozkara S. Gastrointestinal stromal tumours. J Coll Physicians Surg Pak. 2021;31(9):1089–93.CrossRefPubMed
6.
go back to reference Nishida T, Goto O, Raut CP, Yahagi N. Diagnostic and treatment strategy for small gastrointestinal stromal tumors. Cancer. 2016;122(20):3110–8.CrossRefPubMed Nishida T, Goto O, Raut CP, Yahagi N. Diagnostic and treatment strategy for small gastrointestinal stromal tumors. Cancer. 2016;122(20):3110–8.CrossRefPubMed
7.
go back to reference Beham AW, Schaefer IM, Schüler P, Cameron S, Ghadimi BM. Gastrointestinal stromal tumors. Int J Colorectal Dis. 2012;27(6):689–700.CrossRefPubMed Beham AW, Schaefer IM, Schüler P, Cameron S, Ghadimi BM. Gastrointestinal stromal tumors. Int J Colorectal Dis. 2012;27(6):689–700.CrossRefPubMed
8.
go back to reference Qiu H, Zhang P, Feng X, Chen T, Sun X, Yu J, et al. [Changes of diagnosis and treatment for gastrointestinal stromal tumors during a 18-year period in four medical centers of China]. Zhonghua wei chang wai ke za zhi = Chinese. J Gastrointest Surg. 2016;19(11):1265–70. Qiu H, Zhang P, Feng X, Chen T, Sun X, Yu J, et al. [Changes of diagnosis and treatment for gastrointestinal stromal tumors during a 18-year period in four medical centers of China]. Zhonghua wei chang wai ke za zhi = Chinese. J Gastrointest Surg. 2016;19(11):1265–70.
9.
go back to reference Hong X, Choi H, Loyer EM, Benjamin RS, Trent JC, Charnsangavej C. Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluation and surveillance after treatment with imatinib. Radiographics: A Review Publication of the Radiological Society of North America Inc. 2006;26(2):481–95.CrossRefPubMed Hong X, Choi H, Loyer EM, Benjamin RS, Trent JC, Charnsangavej C. Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluation and surveillance after treatment with imatinib. Radiographics: A Review Publication of the Radiological Society of North America Inc. 2006;26(2):481–95.CrossRefPubMed
10.
go back to reference Kiśluk J, Zińczuk J, Kemona A, Guzińska-Ustymowicz K, Żurawska J, Kędra B. Expression of CD117, DOG-1, and IGF-1R in gastrointestinal stromal tumours - an analysis of 70 cases from 2004 to 2010. Przeglad Gastroenterologiczny. 2016;11(2):115–22.PubMed Kiśluk J, Zińczuk J, Kemona A, Guzińska-Ustymowicz K, Żurawska J, Kędra B. Expression of CD117, DOG-1, and IGF-1R in gastrointestinal stromal tumours - an analysis of 70 cases from 2004 to 2010. Przeglad Gastroenterologiczny. 2016;11(2):115–22.PubMed
11.
go back to reference Gomez-Peregrina D, Garcia-Valverde A, Pilco-Janeta D, Serrano C. Liquid biopsy in gastrointestinal stromal tumors: Ready for Prime Time? Curr Treat Options Oncol. 2021;22(4):32.CrossRefPubMed Gomez-Peregrina D, Garcia-Valverde A, Pilco-Janeta D, Serrano C. Liquid biopsy in gastrointestinal stromal tumors: Ready for Prime Time? Curr Treat Options Oncol. 2021;22(4):32.CrossRefPubMed
12.
go back to reference Heitzer E, Haque IS, Roberts CES, Speicher MR. Current and future perspectives of liquid biopsies in genomics-driven oncology. Nat Rev Genet. 2019;20(2):71–88.CrossRefPubMed Heitzer E, Haque IS, Roberts CES, Speicher MR. Current and future perspectives of liquid biopsies in genomics-driven oncology. Nat Rev Genet. 2019;20(2):71–88.CrossRefPubMed
13.
go back to reference Finotti A, Allegretti M, Gasparello J, Giacomini P, Spandidos DA, Spoto G, et al. Liquid biopsy and PCR-free ultrasensitive detection systems in oncology (review). Int J Oncol. 2018;53(4):1395–434.PubMedPubMedCentral Finotti A, Allegretti M, Gasparello J, Giacomini P, Spandidos DA, Spoto G, et al. Liquid biopsy and PCR-free ultrasensitive detection systems in oncology (review). Int J Oncol. 2018;53(4):1395–434.PubMedPubMedCentral
14.
go back to reference Tan B, Li Y, Di Y, Fan L, Zhao Q, Liu Q, et al. Clinical value of peripheral blood microRNA detection in evaluation of SOX regimen as neoadjuvant chemotherapy for gastric cancer. J Clin Lab Anal. 2018;32(4):e22363.CrossRefPubMed Tan B, Li Y, Di Y, Fan L, Zhao Q, Liu Q, et al. Clinical value of peripheral blood microRNA detection in evaluation of SOX regimen as neoadjuvant chemotherapy for gastric cancer. J Clin Lab Anal. 2018;32(4):e22363.CrossRefPubMed
15.
go back to reference Gómez-Peregrina D, García-Valverde A, Pilco-Janeta D, Serrano C. Liquid biopsy in gastrointestinal stromal tumors: Ready for Prime Time? Curr Treat Options Oncol. 2021;22(4):32.CrossRefPubMed Gómez-Peregrina D, García-Valverde A, Pilco-Janeta D, Serrano C. Liquid biopsy in gastrointestinal stromal tumors: Ready for Prime Time? Curr Treat Options Oncol. 2021;22(4):32.CrossRefPubMed
16.
go back to reference Wang D, Dong Z, Wang L, Zhang J, Liu Y, Zhuang X. The diagnostic value of serum CEA and CA19-9 in gastric stromal tumors. Chin J Lab Med. 2019;42:128–34. Wang D, Dong Z, Wang L, Zhang J, Liu Y, Zhuang X. The diagnostic value of serum CEA and CA19-9 in gastric stromal tumors. Chin J Lab Med. 2019;42:128–34.
17.
go back to reference Xu C, Han H, Wang J, Zhang B, Shao Y, Zhang L, et al. Diagnosis value of CD117 and PDGFRA, alone or in combination DOG1, as biomarkers for gastrointestinal stromal tumors. Ann Transl Med. 2015;3(20):308.PubMedPubMedCentral Xu C, Han H, Wang J, Zhang B, Shao Y, Zhang L, et al. Diagnosis value of CD117 and PDGFRA, alone or in combination DOG1, as biomarkers for gastrointestinal stromal tumors. Ann Transl Med. 2015;3(20):308.PubMedPubMedCentral
18.
19.
go back to reference Fan R, Zhong J, Zheng S, Wang Z, Xu Y, Li S, et al. MicroRNA-218 inhibits gastrointestinal stromal tumor cell and invasion by targeting KIT. Tumour Biology: The Journal of the International Society for Oncodevelopmental Biology and Medicine. 2014;35(5):4209–17.CrossRefPubMed Fan R, Zhong J, Zheng S, Wang Z, Xu Y, Li S, et al. MicroRNA-218 inhibits gastrointestinal stromal tumor cell and invasion by targeting KIT. Tumour Biology: The Journal of the International Society for Oncodevelopmental Biology and Medicine. 2014;35(5):4209–17.CrossRefPubMed
20.
go back to reference Hagman Z, Haflidadottir BS, Ansari M, Persson M, Bjartell A, Edsjö A, et al. The tumour suppressor miR-34c targets MET in prostate cancer cells. Br J Cancer. 2013;109(5):1271–8.CrossRefPubMedPubMedCentral Hagman Z, Haflidadottir BS, Ansari M, Persson M, Bjartell A, Edsjö A, et al. The tumour suppressor miR-34c targets MET in prostate cancer cells. Br J Cancer. 2013;109(5):1271–8.CrossRefPubMedPubMedCentral
21.
go back to reference van der Deen M, Taipaleenmäki H, Zhang Y, Teplyuk NM, Gupta A, Cinghu S, et al. MicroRNA-34c inversely couples the biological functions of the runt-related transcription factor RUNX2 and the tumor suppressor p53 in osteosarcoma. J Biol Chem. 2013;288(29):21307–19.CrossRefPubMedPubMedCentral van der Deen M, Taipaleenmäki H, Zhang Y, Teplyuk NM, Gupta A, Cinghu S, et al. MicroRNA-34c inversely couples the biological functions of the runt-related transcription factor RUNX2 and the tumor suppressor p53 in osteosarcoma. J Biol Chem. 2013;288(29):21307–19.CrossRefPubMedPubMedCentral
22.
go back to reference Yang S, Li Y, Gao J, Zhang T, Li S, Luo A, et al. MicroRNA-34 suppresses breast cancer invasion and metastasis by directly targeting Fra-1. Oncogene. 2013;32(36):4294–303.CrossRefPubMed Yang S, Li Y, Gao J, Zhang T, Li S, Luo A, et al. MicroRNA-34 suppresses breast cancer invasion and metastasis by directly targeting Fra-1. Oncogene. 2013;32(36):4294–303.CrossRefPubMed
23.
go back to reference Nannini M, Ravegnini G, Angelini S, Astolfi A, Biasco G, Pantaleo MA. miRNA profiling in gastrointestinal stromal tumors: implication as diagnostic and prognostic markers. Epigenomics. 2015;7(6):1033–49.CrossRefPubMed Nannini M, Ravegnini G, Angelini S, Astolfi A, Biasco G, Pantaleo MA. miRNA profiling in gastrointestinal stromal tumors: implication as diagnostic and prognostic markers. Epigenomics. 2015;7(6):1033–49.CrossRefPubMed
24.
go back to reference Reichardt P, Demetri GD, Jeffers M, Kang YK, Blay JY, Rutkowski P, et al. Mutational analysis of plasma DNA from patients (pts) in the phase III GRID study of regorafenib (REG) versus placebo (PL) in tyrosine kinase inhibitor (TKI)-refractory GIST: correlating genotype with clinical outcomes. Oncol Res Treat. 2014;37:58. Reichardt P, Demetri GD, Jeffers M, Kang YK, Blay JY, Rutkowski P, et al. Mutational analysis of plasma DNA from patients (pts) in the phase III GRID study of regorafenib (REG) versus placebo (PL) in tyrosine kinase inhibitor (TKI)-refractory GIST: correlating genotype with clinical outcomes. Oncol Res Treat. 2014;37:58.
25.
go back to reference Maier J, Lange T, Kerle I, Specht K, Bruegel M, Wickenhauser C, et al. Detection of mutant free circulating tumor DNA in the plasma of patients with gastrointestinal stromal tumor harboring activating mutations of CKIT or PDGFRA. Clin cancer Research: Official J Am Association Cancer Res. 2013;19(17):4854–67.CrossRef Maier J, Lange T, Kerle I, Specht K, Bruegel M, Wickenhauser C, et al. Detection of mutant free circulating tumor DNA in the plasma of patients with gastrointestinal stromal tumor harboring activating mutations of CKIT or PDGFRA. Clin cancer Research: Official J Am Association Cancer Res. 2013;19(17):4854–67.CrossRef
26.
go back to reference Kuo CY, Lee MH, Tsai MJ, Yang CJ, Hung JY, Chong IW. The factors Predicting Concordant epidermal growth factor receptor (EGFR) mutation detected in Liquid/Tissue biopsy and the related clinical outcomes in patients of Advanced Lung Adenocarcinoma with EGFR mutations. J Clin Med. 2019;8(11). Kuo CY, Lee MH, Tsai MJ, Yang CJ, Hung JY, Chong IW. The factors Predicting Concordant epidermal growth factor receptor (EGFR) mutation detected in Liquid/Tissue biopsy and the related clinical outcomes in patients of Advanced Lung Adenocarcinoma with EGFR mutations. J Clin Med. 2019;8(11).
28.
go back to reference Friedman JH. Stochastic gradient boosting. Comput Stat Data Anal. 2002;38. Friedman JH. Stochastic gradient boosting. Comput Stat Data Anal. 2002;38.
29.
go back to reference Petralia F, Wang P, Yang J, Tu Z. Integrative random forest for gene regulatory network inference. Bioinf (Oxford England). 2015;31(12):i197–205. Petralia F, Wang P, Yang J, Tu Z. Integrative random forest for gene regulatory network inference. Bioinf (Oxford England). 2015;31(12):i197–205.
30.
go back to reference Sugano K. Screening of gastric cancer in Asia. Best Pract Res Clin Gastroenterol. 2015;29(6):895–905.CrossRefPubMed Sugano K. Screening of gastric cancer in Asia. Best Pract Res Clin Gastroenterol. 2015;29(6):895–905.CrossRefPubMed
31.
go back to reference Sui C, Lin C, Tao T, Guan W, Zhang H, Tao L, et al. Prognostic significance of serum CA125 in the overall management for patients with gastrointestinal stromal tumors. BMC Gastroenterol. 2023;23(1):25.CrossRefPubMedPubMedCentral Sui C, Lin C, Tao T, Guan W, Zhang H, Tao L, et al. Prognostic significance of serum CA125 in the overall management for patients with gastrointestinal stromal tumors. BMC Gastroenterol. 2023;23(1):25.CrossRefPubMedPubMedCentral
32.
go back to reference Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10(1):12.CrossRefPubMedPubMedCentral Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10(1):12.CrossRefPubMedPubMedCentral
33.
go back to reference Perez DR, Baser RE, Cavnar MJ, Balachandran VP, Antonescu CR, Tap WD, et al. Blood neutrophil-to-lymphocyte ratio is prognostic in gastrointestinal stromal tumor. Ann Surg Oncol. 2013;20(2):593–9.CrossRefPubMed Perez DR, Baser RE, Cavnar MJ, Balachandran VP, Antonescu CR, Tap WD, et al. Blood neutrophil-to-lymphocyte ratio is prognostic in gastrointestinal stromal tumor. Ann Surg Oncol. 2013;20(2):593–9.CrossRefPubMed
Metadata
Title
Intelligent identification system of gastric stromal tumors based on blood biopsy indicators
Authors
Shangjun Han
Meijuan Song
Jiarui Wang
Yalong Huang
Zuxi Li
Aijia Yang
Changsheng Sui
Zeping Zhang
Jiling Qiao
Jing Yang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2023
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-023-02324-y

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