Evidence map›Paper›PMID 41180985›Full record

ArticleWorld journal of gastroenterology2025

Insights into the GALAD score: A new optimal cut-off for hepatocellular carcinoma.

Erica Villa, Rossella Donghia, Sergio Coletta, Caterina Bonfiglio, Rosina Maria Critelli, Anna Ancona, Endrit Shahini, Palma Aurelia Iacovazzi, Raffaele Cozzolongo, Francesca Pavone and 6 more

Abstract read
In one paragraph

Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Erica VillaDepartment of Gastroenterology, University of Modena and Reggio Emilia, Modena 41124, Emilia-Romagna, Italy.
Rossella DonghiaData Science Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Bari, Italy.
Sergio ColettaCore Facility Biobank, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Bari, Italy.
Caterina BonfiglioData Science Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Bari, Italy.
Rosina Maria CritelliDepartment of Chimomo, University of Modena and Reggio Emilia, Modena 41124, Emilia-Romagna, Italy.
Anna AnconaCore Facility Biobank, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Bari, Italy.
Endrit ShahiniGastroenterology Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Puglia, Italy.
Palma Aurelia IacovazziClinical Pathology Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Bari, Italy.
Raffaele CozzolongoGastroenterology Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Puglia, Italy.
Francesca PavoneGastroenterology Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Puglia, Italy.
Nicola CarellaClinical Research Unit, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Puglia, Italy.
Patrizia PontissoDepartment of Medicine, Azienda Ospedaliera-Università Padova, Padova 35123, Veneto, Italy.
Andrea MartiniDepartment of Medicine, Azienda Ospedaliera-Università Padova, Padova 35123, Veneto, Italy.
Sherin Al AouaDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover 30625, Lower Saxony, Germany.
Heike BantelDepartment of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover 30625, Lower Saxony, Germany.
Gianluigi GiannelliScientific Direction, National Institute of Gastroenterology-IRCCS "Saverio de Bellis", Castellana Grotte 70013, Puglia, Italy. gianluigi.giannelli@irccsdebellis.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic liver disease (CLD) causes approximately two million deaths each year, and its clinical diagnosis and management remain challenging. Ultrasound is currently the most widely used technique for disease detection.

aimTo propose a practical cut-off value for identifying patients with hepatocellular carcinoma (HCC) among those with compensated advanced CLD or healthy individuals using the GALAD score, an algorithm based on a formula that incorporates gender, age, serum alpha-fetoprotein (AFP), AFP-L3, and des-gamma-carboxy prothrombin values.

methodsThis cross-sectional analysis was conducted using prospectively collected data from five cohorts (

resultsUsing healthy subjects as reference, a GALAD score cut-off of -1.67 identified HCC with a sensitivity of 89.77% and specificity of 97.59%. Individuals with GALAD values > -1.67 exhibited a moderate to very high probability (over 90%) of having HCC. When cirrhotic patients were used as the reference category, a cut-off of -0.77 yielded a sensitivity of 78.17% and a specificity of 89.55%.

conclusionWe strongly recommend incorporating this GALAD cut-off into clinical guidelines for the screening of patients with a compensated advanced CLD who are at high risk of developing HCC. Given the rapid global rise in metabolic-associated steatotic liver disease (MASLD)-related CLD, future research should prioritize larger MASLD cohorts to establish the most appropriate GALAD cut-off for diagnostic use, compared to healthy controls and to patients with other forms of CLD.

Indexed as

Carcinoma, HepatocellularLiver CirrhosisLiver NeoplasmsAdultAgedAge FactorsAlgorithmsalpha-FetoproteinsBiomarkersBiomarkers, TumorCross-Sectional StudiesFemaleHumansItalyMaleMiddle AgedacarboxyprothrombinAFP protein, humanalpha-FetoproteinsBiomarkersBiomarkers, TumorProtein PrecursorsProthrombinChronic liver diseaseCirrhosisEarly detectionGALADHepatocellular carcinoma

Identifiers

PMID41180985
PMCPMC12576547

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.