GALAD Score for Hepatocellular Carcinoma Detection in Comparison with Liver Ultrasound and Proposal of GALADUS Score

Ju Dong Yang, Benyam D Addissie, Kristin C Mara, William S Harmsen, Jianliang Dai, Ning Zhang, Nicha Wongjarupong, Hawa M Ali, Hamdi A Ali, Fatima A Hassan, Sravanthi Lavu, Jessica L Cvinar, Nasra H Giama, Catherine D Moser, Katsuyuki Miyabe, Loretta K Allotey, Alicia Algeciras-Schimnich, J Paul Theobald, Melissa M Ward, Mindie H Nguyen, Alex S Befeler, K Rajender Reddy, Myron Schwartz, Denise M Harnois, Hiroyuki Yamada, Sudhir Srivastava, Jo Ann Rinaudo, Gregory J Gores, Ziding Feng, Jorge A Marrero, Lewis R Roberts, Ju Dong Yang, Benyam D Addissie, Kristin C Mara, William S Harmsen, Jianliang Dai, Ning Zhang, Nicha Wongjarupong, Hawa M Ali, Hamdi A Ali, Fatima A Hassan, Sravanthi Lavu, Jessica L Cvinar, Nasra H Giama, Catherine D Moser, Katsuyuki Miyabe, Loretta K Allotey, Alicia Algeciras-Schimnich, J Paul Theobald, Melissa M Ward, Mindie H Nguyen, Alex S Befeler, K Rajender Reddy, Myron Schwartz, Denise M Harnois, Hiroyuki Yamada, Sudhir Srivastava, Jo Ann Rinaudo, Gregory J Gores, Ziding Feng, Jorge A Marrero, Lewis R Roberts

Abstract

Background: 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 with liver ultrasound for detection of HCC.

Methods: A single-center cohort of 111 HCC patients 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 II HCC Study were analyzed.

Results: 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 cutoff 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; cutoff -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; cutoff -0.18, sensitivity 95%, specificity 91%).

Conclusions: The performance of the GALAD score was superior to ultrasound for HCC detection. The GALADUS score further enhanced the performance of the GALAD score.

Impact: The GALAD score was validated in the United States.

Conflict of interest statement

Conflict of Interest:

LRR has received grant funding from BTG, Gilead Sciences and Wako Diagnostics; HY is an employee of Wako Diagnostics. No other potential conflict of interest for the rest of authors.

©2018 American Association for Cancer Research.

Figures

Figure 1.
Figure 1.
The ROC of GALAD scores for HCC diagnosis in each subgroup (Mayo cohort) X- axis: Specificity; Y-axis: Sensitivity, 1A- The ROC of GALAD score for detection of HCC, 1B- The ROC of GALAD score for detection of early stage HCC
Figure 2.
Figure 2.
The ROC of GALAD scores for HCC diagnosis in each subgroups of patients with different etiologies (EDRN cohort), X- axis: Specificity; Y-axis: Sensitivity
Figure 3.
Figure 3.
The ROC of GALADUS scores for HCC diagnosis, X- axis: Specificity; Y-axis: Sensitivity, 3A- The ROC of GALADUS score for detection of HCC, 3B- The ROC of GALADUS score for detection of early stage HCC

Source: PubMed

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