The GALAD score performs better than AFP in hepatocellular carcinoma screening: a single-centre, case-control study in Malaysia.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Experimental Hepatology Pub Date : 2025-03-01 Epub Date: 2025-03-25 DOI:10.5114/ceh.2025.148321

Wing Hang Woo, Khairul Najmi Muhammad Nawawi, Deborah Chia Hsin Chew, Wei Hao Kok, Zhiqin Wong, Azlanudin Azman, Nur Yazmin Yaacob, Munirah Md Mansor, Hanita Othman, Raja Affendi Raja Ali

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引用次数: 0

Abstract

Aim of the study: Hepatocellular carcinoma (HCC) in Malaysia is a growing health concern, despite regular liver ultrasound and α-fetoprotein (AFP) surveillance. The GALAD model incorporates AFP, lens culinaris agglutinin- reactive α-fetoprotein (AFP-L3), protein induced by vitamin K antagonist-II (PIVKA-II), gender and age to predict the probability of HCC. Our objective was to evaluate the diagnostic ability of GALAD compared to AFP in HCC screening.

Material and methods: A single-centre, case control study recruited newly diagnosed HCC and cirrhotic patients. Serum biomarkers were quantified using a microfluidic-based automated immunoanalyzer. The diagnostic ability of AFP, AFP-L3, PIVKA-II and GALAD was assessed using receiver operating characteristic curve (ROC) and corresponding area under the curve (AUC) analysis.

Results: Among the 44 HCC cases, GALAD score achieved the highest AUC value of 0.94 (95% confidence interval [CI]: 0.90-0.98, p < 0.0001) significantly surpassing AFP (0.89), AFP-L3 (0.84) and PIVKA-II (0.88). The GALAD score demonstrated 84.1% sensitivity and 93.8% specificity at the standard cut-off (-0.63) and 88.6%/92.2% at its best cut-off (-1.035) for detecting any stage of HCC, outperforming AFP (79.5%/92.2%), AFP-L3 (59.1%/94.9%) and PIVKA-II (79.5%/84.9%). The sensitivity of the GALAD score was 100% in earlystage HCC (BCLC0/A).

Conclusions: GALAD outperformed conventional biomarkers, facilitating early detection, improved treatment options and ultimately a higher survival rate for HCC patients.

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GALAD评分在肝细胞癌筛查中的表现优于AFP：马来西亚的一项单中心病例对照研究。

研究目的：尽管定期进行肝脏超声和α-胎蛋白（AFP）监测，马来西亚的肝细胞癌（HCC）仍是一个日益严重的健康问题。GALAD模型结合AFP、culinaris凝集素-反应性α-胎蛋白（AFP- l3）、维生素K拮抗剂- ii （PIVKA-II）诱导的蛋白、性别和年龄来预测HCC的发生概率。我们的目的是评估GALAD与AFP在HCC筛查中的诊断能力。材料和方法：一项单中心病例对照研究招募了新诊断的HCC和肝硬化患者。使用基于微流体的自动免疫分析仪定量血清生物标志物。采用受试者工作特征曲线（ROC）和曲线下面积（AUC）分析评价AFP、AFP- l3、PIVKA-II和GALAD的诊断能力。结果：44例HCC患者中，GALAD评分AUC值最高，为0.94(95%可信区间[CI]: 0.90 ~ 0.98, p < 0.0001)，显著高于AFP（0.89）、AFP- l3（0.84）和PIVKA-II（0.88）。GALAD评分在检测任何阶段HCC的标准临界值（-0.63）下的敏感性为84.1%，特异性为93.8%，最佳临界值（-1.035）为88.6%/92.2%，优于AFP（79.5%/92.2%）、AFP- l3（59.1%/94.9%）和PIVKA-II（79.5%/84.9%）。GALAD评分对早期HCC （BCLC0/A）的敏感性为100%。结论：GALAD优于传统的生物标志物，促进了HCC患者的早期发现，改善了治疗选择，最终提高了生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

2.80

自引率

0.00%

发文量

期刊介绍： Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.