High levels of fatty acid-binding protein (FABP) 4 might be indicative of malignant phenotype and poor prognosis in gastrointestinal stromal tumor (GIST), according to a new study published in the Journal of Clinical Laboratory Analysis. 

Complete radical resection is the standard of care for localized GISTs, but some patients cannot have surgery due to late-stage disease. In these cases, there are some targeted therapies available that can be used to treat patients, such as imatinib. For patients whose disease does not respond to imatinib treatment, there are other options that can be tried, but their efficacies are usually low.

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It is, therefore, very important to have specific biomarkers that can predict the course of the disease to ensure the right treatment is chosen.

It was already known that FABPs are involved in tumorigenesis. FABP4 is the most studied FABP, and it is known to be associated with the development of a variety of tumors. However, its role in the occurrence and development of GIST has not been investigated.

In the present study, a team of researchers from China aimed to investigate the expression and prognostic value of FABP4 in GIST. 

Using immunohistochemical analysis of tissue microarrays, they evaluated the expression of the protein in 125 patients with GIST and then analyzed the relationship between FABP4 expression and patients’ clinicopathological features and prognoses.

They found that FABP4 expression correlated with tumor size and mitotic index. They also found that FABP4 levels, tumor size, mitotic index, and high AFIP (Armed Forces Institute of Pathology)-Miettinen risk were independent prognostic factors. Finally, the researchers showed that patients with high FABP4 expression had lower 5-year survival rates. 

“Hence, FABP4 expression is a novel and valuable marker for judging the prognosis of GIST and is an independent indicator of the degree of risk,” they concluded.


Zang WJ, Wang ZN, Hu YL, Huang H, Ma P. Expression of fatty acid-binding protein-4 in gastrointestinal stromal tumors and its significance for prognosis. J Clin Lab Anal. Published online September 24, 2021. doi:10.1002/jcla.24017