Citations 2
GALAD Score for Hepatocellular Carcinoma Detection in Comparison with Liver Ultrasound and Proposal of GALADUS Score
Yang, Ju Dong , Addissie, Benyam D., Mara, Kristin C. , Harmsen, William S. , Dai, Jianliang , Zhang, Ning , Wongjarupong, Nicha , Ali, Hawa M. , Ali, Hamdi A. , Hassan, Fatima, Lavu, Sravanthi , Cvinar, Jessica, Giama, Nasra H., Moser, Catherine D., Miyabe, Katsuyuki , Allotey, Loretta K., Theobald, Jannick , Ward, Melissa M., Nguyen, Mindie H. , Befeler, Alex S. , Reddy, K. Rajender , Schwartz, Myron , Harnois, Denise M. , Srivastava, Sudhir , Rinaudo, Jo Ann, Feng, Ziding , Marrero, Jorge A. , Roberts, Lewis R. , Hassan, Fatima A, Cvinar, Jessica L, Theobald, J Paul, Roberts, Lewis R , Miyabe, Katsuyuki , Mara, Kristin C , Yang, Ju Dong , Algeciras‐Schimnich, Alicia , Theobald, J. Paul, Yamada, Hiroyuki , Gores, Gregory J.
Cancer Epidemiology, Biomarkers & Prevention | November 21, 2018 | Volume: 28 | Issue: 3 | Pages: 531-538
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.
Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation
Chaiteerakij, Roongruedee , Zhang, Xiaodan , Addissie, Benyam D., Harmsen, William S. , Theobald, Paul J., Peters, Brian E., Balsanek, Joseph G., Ward, Melissa M., Giama, Nasra H., Moser, Catherine D., Oseini, Abdul M., Umeda, Naoki, Venkatesh, Sudhakar K. , Harnois, Denise M. , Satomura, Shinji , Snyder, Melissa R. , Therneau, Terry M. , Roberts, Lewis R. , Chaiteerakij, Roongruedee , Mohamed, Essa A. , Charlton, Michael , Yamada, Hiroyuki , Algeciras‐Schimnich, Alicia , Roberts, Lewis R , Venkatesh, Sudhakar K
Liver Transplantation | March 17, 2015 | Volume: 21 | Issue: 5 | Pages: 599-606
Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyprothrombin (DCP) predicted HCC recurrence after transplantation. A retrospective cohort study of 313 HCC patients undergoing transplantation between 2000 and 2008 was conducted, and 48 (15.3%) developed recurrence during a median follow‐up of 90.8 months. The 127 patients with available serum drawn before transplantation were included; they included 86 without recurrence and 41 with recurrence. Serum was tested for AFP, AFP‐L3%, and DCP in a blinded fashion with the μTASWako i30 immunoanalyzer. All biomarkers were significantly associated with HCC recurrence. The hazard ratios (HRs) were 3.5 [95% confidence interval (CI), 1.9‐6.7; P < 0.0001] for DCP ≥ 7.5 ng/mL and 2.8 (95% CI, 1.4‐5.4; P = 0.002) for AFP ≥ 250 ng/mL. The HR increased to 5.2 (95% CI, 2.3‐12.0; P < 0.0001) when AFP ≥ 250 ng/mL and DCP ≥7.5 ng/mL were considered together. When they were combined with the Milan criteria, the HR increased from 2.6 (95% CI, 1.4‐4.7; P = 0.003) for outside the Milan criteria to 8.6 (95% CI, 3.0‐24.6; P < 0.0001) for outside the Milan criteria and AFP ≥ 250 ng/mL and to 7.2 (95% CI, 2.8‐18.1; P < 0.0001) for outside the Milan criteria and DCP ≥7.5 ng/mL. Our findings suggest that biomarkers are useful for predicting the risk of HCC recurrence after transplantation. Using both biomarkers and the Milan criteria may be better than using the Milan criteria alone in optimizing the decision of liver transplantation eligibility. Liver Transpl 21:599–606, 2015. © 2015 AASLD.