Comparative performance of the GAAD and ASAP scores in predicting early-stage hepatocellular carcinoma.

IF 4.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Report Pub Date : 2025-07-30 eCollection Date: 2025-01-01 DOI:10.1093/gastro/goaf074

Chongkonrat Maneenil, Pimsiri Sripongpun, Naichaya Chamroonkul, Piraya Tantisaranon, Roongrueng Jarumanokul, Maseetoh Samaeng, Yupawadee Yamsuwan, Lalita Fonghoi, Amornkan Numit, Teerha Piratvisuth, Apichat Kaewdech

{"title":"Comparative performance of the GAAD and ASAP scores in predicting early-stage hepatocellular carcinoma.","authors":"Chongkonrat Maneenil, Pimsiri Sripongpun, Naichaya Chamroonkul, Piraya Tantisaranon, Roongrueng Jarumanokul, Maseetoh Samaeng, Yupawadee Yamsuwan, Lalita Fonghoi, Amornkan Numit, Teerha Piratvisuth, Apichat Kaewdech","doi":"10.1093/gastro/goaf074","DOIUrl":null,"url":null,"abstract":"Background: The gender, age, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (GAAD) score is a recent predictive tool for hepatocellular carcinoma (HCC) but lacks comparison with the AFP, Sex, Age, and Protein induced by vitamin K absence-II (ASAP) score, which uses similar parameters with different assays and formulas. Our study aimed to evaluate the performance differences between these two scores.Methods: Blood samples from 622 patients with chronic liver diseases at Songklanagarind Hospital between 20 April 2023 and 31 December 2023 were analyzed. The cutoffs for the ASAP and GAAD scores were established as 0.526 and 2.570, respectively, and HCC diagnoses followed the European Association for the Study of the Liver (EASL) or the American Association for the Study of Liver Diseases (AASLD) guidelines.Results: HCC diagnoses were observed in 28.6% of patients, with 48.3% diagnosed with early-stage diseases (Barcelona Clinic Liver Cancer stage 0 = 23, A = 63). Hepatitis B virus infection (40.4%) and metabolic dysfunction-associated steatotic liver disease (21.3%) were predominant causes. The area under the receiver operating characteristic curve (AUROCs) of the ASAP and GAAD scores for predicting all-stage HCC were comparable (0.933 vs 0.937, P = 0.578). For early-stage HCC, AUROCs were 0.880 (ASAP) and 0.891 (GAAD) (P = 0.353). Sensitivity and specificity for predicting all-stage HCC were 83.15% and 91.44% (ASAP), and 82.58% and 89.64% (GAAD), respectively; these values for early-stage HCC were 66.28% and 91.44% (ASAP) and 67.44% and 89.64% (GAAD). Subgroup analyses by cirrhosis and etiology showed no significant differences. New cutoff values of -0.083 (ASAP) and 1.725 (GAAD) were identified for at least 80% sensitivity and specificity for predicting early-stage HCC.Conclusion: Both the GAAD and ASAP scores demonstrated excellent and comparable abilities in HCC detection across all stages, unaffected by cirrhosis or etiological differences.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf074"},"PeriodicalIF":4.2000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311291/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Report","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/gastro/goaf074","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The gender, age, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (GAAD) score is a recent predictive tool for hepatocellular carcinoma (HCC) but lacks comparison with the AFP, Sex, Age, and Protein induced by vitamin K absence-II (ASAP) score, which uses similar parameters with different assays and formulas. Our study aimed to evaluate the performance differences between these two scores.

Methods: Blood samples from 622 patients with chronic liver diseases at Songklanagarind Hospital between 20 April 2023 and 31 December 2023 were analyzed. The cutoffs for the ASAP and GAAD scores were established as 0.526 and 2.570, respectively, and HCC diagnoses followed the European Association for the Study of the Liver (EASL) or the American Association for the Study of Liver Diseases (AASLD) guidelines.

Results: HCC diagnoses were observed in 28.6% of patients, with 48.3% diagnosed with early-stage diseases (Barcelona Clinic Liver Cancer stage 0 = 23, A = 63). Hepatitis B virus infection (40.4%) and metabolic dysfunction-associated steatotic liver disease (21.3%) were predominant causes. The area under the receiver operating characteristic curve (AUROCs) of the ASAP and GAAD scores for predicting all-stage HCC were comparable (0.933 vs 0.937, P = 0.578). For early-stage HCC, AUROCs were 0.880 (ASAP) and 0.891 (GAAD) (P = 0.353). Sensitivity and specificity for predicting all-stage HCC were 83.15% and 91.44% (ASAP), and 82.58% and 89.64% (GAAD), respectively; these values for early-stage HCC were 66.28% and 91.44% (ASAP) and 67.44% and 89.64% (GAAD). Subgroup analyses by cirrhosis and etiology showed no significant differences. New cutoff values of -0.083 (ASAP) and 1.725 (GAAD) were identified for at least 80% sensitivity and specificity for predicting early-stage HCC.

Conclusion: Both the GAAD and ASAP scores demonstrated excellent and comparable abilities in HCC detection across all stages, unaffected by cirrhosis or etiological differences.

Abstract Image

查看原文本刊更多论文

GAAD和ASAP评分预测早期肝细胞癌的比较。

背景：性别、年龄、甲胎蛋白（AFP）和去- γ -羧基凝血酶原（GAAD）评分是肝细胞癌（HCC）的最新预测工具，但缺乏与AFP、性别、年龄和维生素K缺乏症诱导的蛋白（ASAP）评分的比较，后者使用相似的参数，但不同的检测方法和公式。我们的研究旨在评估这两个分数之间的表现差异。方法：对Songklanagarind医院2023年4月20日至2023年12月31日期间622例慢性肝病患者的血液样本进行分析。ASAP和GAAD评分的临界值分别为0.526和2.570，HCC的诊断遵循欧洲肝脏研究协会（EASL）或美国肝脏疾病研究协会（AASLD）的指南。结果：28.6%的患者被诊断为HCC，其中48.3%的患者被诊断为早期疾病（巴塞罗那临床肝癌分期0 = 23,A = 63）。乙型肝炎病毒感染（40.4%）和代谢功能障碍相关的脂肪变性肝病（21.3%）是主要原因。ASAP和GAAD评分预测全期HCC的受试者工作特征曲线下面积（auroc）具有可比性（0.933 vs 0.937, P = 0.578）。早期HCC的auroc分别为0.880 （ASAP）和0.891 (GAAD) （P = 0.353）。预测全期HCC的敏感性和特异性分别为83.15%、91.44% （ASAP）和82.58%、89.64% (GAAD)；早期HCC （ASAP）分别为66.28%和91.44%，GAAD分别为67.44%和89.64%。肝硬化和病因亚组分析无显著差异。新的临界值为-0.083 （ASAP）和1.725 (GAAD)，预测早期HCC的敏感性和特异性至少为80%。结论：GAAD评分和ASAP评分在所有阶段的HCC检测中都表现出优异的和可比较的能力，不受肝硬化或病因差异的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Gastroenterology Report Medicine-Gastroenterology

CiteScore

4.60

自引率

2.80%

发文量

审稿时长

8 weeks

期刊介绍： Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.