ArticleHepatology (Baltimore, Md.)2022
GALAD demonstrates high sensitivity for HCC surveillance in a cohort of patients with cirrhosis.
Article in Hepatology (Baltimore, Md.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers.
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Who cites it
99 citing papers in PubMed, 164 citations in OpenAlex.
- Benefits and harms of hepatocellular carcinoma screening outreach in patients with cirrhosis: a multicenter randomized clinical trial.Journal of the National Cancer Institute · 2025Trial
- A Phase 3 Biomarker Validation of GALAD for the Detection of Hepatocellular Carcinoma in Cirrhosis.Gastroenterology · 2025Trial
- Trial
- Hepatocellular carcinoma surveillance may be associated with potential psychological harms in patients with cirrhosis.Hepatology (Baltimore, Md.) · 2024Trial
- The versatile interplay between steatotic liver disease and liver cancer.Nature reviews. Cancer · 2026Review
- Comparison of diagnostic performance of GAAD, GALAD, and ASAP scores for detecting hepatocellular carcinoma in advanced liver fibrosis patients.Advances in laboratory medicine · 2026Article
- Biomarkers for the Diagnosis of Cirrhosis and Cirrhosis-Related Complications.Gastroenterology clinics of North America · 2026Review
- Changes in Liver Disease Etiology Support a Lower Alpha-Fetoprotein Threshold for Hepatocellular Carcinoma Screening.Gastroenterology · 2026Article
- Validation of the GALAD model for diagnosing HBV-related hepatocellular carcinoma in Chinese patients.Clinics (Sao Paulo, Brazil) · 2026Article
- Advancing Precision Oncology Through Modeling of Longitudinal and Multimodal Data.IEEE reviews in biomedical engineering · 2026Review
- HES V2.0 surpasses GALAD for HCC detection: a review of multi-dimensional biomarker scores and studies.Hepatic oncology · 2025Review
- Protein Induced by Vitamin K Absence or Antagonist-II: Significantly Elevated in Obstructive Jaundice and Sepsis Patients Without Hepatocellular Carcinoma.Journal of clinical laboratory analysis · 2025Article
- Integrating GPC3 with Other Biomarkers to Improve the Diagnosis of Early-Stage Liver Cancer.Pathogens (Basel, Switzerland) · 2025Article
- Insights into the GALAD score: A new optimal cut-off for hepatocellular carcinoma.World journal of gastroenterology · 2025Article
- BALAD-2 Emerges as the Most Accurate Prognostic Model in Hepatocellular Carcinoma: Results from a Biobank-Based Cohort Study.Cancers · 2025Article
- Sustained AFP-L3 or DCP expression is associated with progression risk and inferior outcomes in unresectable hepatocellular carcinoma.Clinical and experimental medicine · 2025Article
- Current Tools to Diagnose and Predict Hepatocellular Carcinoma: Relevance to HIV and Hepatitis B Virus Coinfection.Current HIV/AIDS reports · 2025Review
- Score-based prediction model for female hepatocellular carcinoma surveillance in asymptotic HBsAg carriers: a multicenter cohort study in China.Journal of the National Cancer Center · 2025Article
- The Roles and Clinical Significance of Major Hepatic-Derived Metabolites in Hepatocellular Carcinoma.Journal of gastroenterology and hepatology · 2025Review
- Article
39 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsMost patients with HCC are diagnosed at a late stage, highlighting the need for more accurate surveillance tests. Although biomarkers for HCC early detection have promising data in Phase 2 case-control studies, evaluation in cohort studies is critical prior to adoption in practice. We leveraged a prospective cohort of patients with Child-Pugh A or B cirrhosis who were followed until incident HCC, liver transplantation, death, or loss to follow-up. We used a prospective specimen collection, retrospective, blinded evaluation design for biomarker evaluation of GALAD (gender × age × log alpha-fetoprotein [AFP] × des-gamma-carboxy prothrombin), longitudinal GALAD, and the HCC Early Detection Screening (HES) algorithm-compared to AFP-using patient-level sensitivity and screening-level specificity. APPROACH AND
resultsOf 397 patients with cirrhosis, 42 developed HCC (57.1% early stage) over a median of 2.0 years. Longitudinal GALAD had the highest c-statistic for HCC detection (0.85; 95% CI, 0.77-0.92) compared to single-time point GALAD (0.79; 95% CI, 0.71-0.87), AFP (0.77; 95% CI, 0.69-0.85), and HES (0.76; 95% CI, 0.67-0.83). When specificity was fixed at 90%, the sensitivity for HCC of single-time point and longitudinal GALAD was 54.8% and 66.7%, respectively, compared to 40.5% for AFP. Sensitivity for HCC detection was higher when restricted to patients with biomarker assessment within 6 months prior to HCC diagnosis, with the highest sensitivities observed for single-time point GALAD (72.0%) and longitudinal GALAD (64.0%), respectively. Sensitivity of single-time point and longitudinal GALAD for early-stage HCC was 53.8% and 69.2%, respectively.
conclusionGALAD demonstrated high sensitivity for HCC detection in a cohort of patients with cirrhosis. Validation of these results is warranted in large Phase 3 data sets.
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