GALAD Score for Hepatocellular Carcinoma Detection in Comparison to Liver Ultrasound and Proposal of GALADUS Score. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology Yang, J. D., Addissie, B. D., Mara, K. C., Harmsen, W. S., Dai, J. n., Zhang, N. n., Wongjarupong, N. n., Ali, H. M., Ali, H. A., Hassan, F. A., Lavu, S. n., Cvinar, J. L., Giama, N. H., Moser, C. D., Miyabe, K. n., Allotey, L. K., Algeciras-Schimnich, A. n., Theobald, J. P., Ward, M. M., Nguyen, M. H., Befeler, A. S., Reddy, K. R., Schwartz, M. n., Harnois, D. M., Yamada, H. n., Srivastava, S. n., Rinaudo, J. A., Gores, G. J., Feng, Z. n., Marrero, J. A., Roberts, L. R. 2018


The GALAD score is a serum biomarker-based model that predicts the probability of having hepatocellular carcinoma (HCC) in patients with chronic liver disease. We aimed to assess the performance of the GALAD score in comparison to liver ultrasound for detection of HCC.A single center cohort of 111 HCC and 180 controls with cirrhosis or chronic hepatitis B and a multicenter cohort of 233 early HCC and 412 cirrhosis patients from the Early Detection Research Network (EDRN) Phase 2 HCC Study were analyzed.The area under the ROC curve (AUC) of the GALAD score for HCC detection was 0.95 [95% confidence interval (CI): 0.93-97], which was higher than the AUC of ultrasound (0.82, P<0.01). At a cut off of -0.76, the GALAD score had a sensitivity of 91% and a specificity of 85% for HCC detection. The AUC of the GALAD score for early stage HCC detection remained high at 0.92 [95%CI: 0.88-0.96] (cut off -1.18, sensitivity 92%, specificity 79%). The AUC of the GALAD score for HCC detection was 0.88 (95% CI, 0.85-0.91) in the EDRN cohort. The combination of GALAD and ultrasound (GALADUS score) further improved the performance of the GALAD score in the single center cohort, achieving an AUC of 0.98 [95%CI: 0.96-0.99] (cut off -0.18, sensitivity 95%, specificity 91%).The performance of the GALAD score was superior to ultrasound for HCC detection. The GALADUS score further enhanced the performance of the GALAD score.The GALAD score was validated in the US.

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