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Comparison between models for detecting hepatocellular carcinoma in patients with chronic liver diseases of various etiologies:ASAP score versus GALAD score

摘要Background:Diagnostic panels based on multiple biomarkers and clinical characteristics are considered more favorable than individual biomarker to diagnose hepatocellular carcinoma(HCC).Based on age,sex,alpha-fetoprotein(AFP),and protein induced by vitamin K absence Ⅱ(PIVKA-Ⅱ)with/without AFP-L3,ASAP and GALAD models are potential diagnostic panels.The diagnostic performances of these two panels were compared relative to HCC detection among patients with various etiologies of chronic liver diseases(CLDs).Methods:A multicenter case-control study recruited CLDs patients with and without HCC from 14 Chi-nese hospitals.The etiologies of CLDs included hepatitis B virus(HBV),hepatitis C virus(HCV),alcoholic liver disease(ALD),and nonalcoholic fatty liver disease(NAFLD).Using area under the receiver operating characteristic curve(AUC)values,the diagnostic performances of ASAP and GALAD models were com-pared to detect HCC among patients with various etiologies of CLDs.Results:Among 248 HCC patients and 722 CLD controls,the ASAP model demonstrated the highest AUC(0.886)to detect HCC at any stage,outperforming the GALAD model(0.853,P=0.001),as well as any individual biomarker(0.687-0.799,all P<0.001).In the subgroup analysis of various CLDs etiologies,the ASAP model outperformed the GALAD model to HCC independent of CLDs etiology.In addition,the ASAP model performed better in detecting early-stage(BCLC stage O/A)HCC versus the GALAD model.Conclusions:Despite using one less laboratory variable(AFP-L3),the ASAP model demonstrated better diagnostic performance than the GALAD model to detect all-stage HCC among patients with various eti-ologies of CLDs-related HCC.

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作者单位 Department of Hepatobiliary and Pancreatic Surgery,General Surgery Center,First Hospital of Jilin University,Changchun 130021,China;Department of Graduate,Bengbu Medical University,Bengbu 233000,China [1] Cancer Center,First Hospital of Jilin University,Changchun 130021,China [2] Department of Hepatobiliary and Pancreatic Surgery,General Surgery Center,First Hospital of Jilin University,Changchun 130021,China;Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University(Naval Medical University),Shanghai 200438,China [3] Department of Clinical Laboratory,Peking University First Hospital,Beijing 100034,China [4] Department of Gastroenterology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China [5] Department of Clinical Laboratory,Gansu Provincial Hospital,Lanzhou 730000,China [6] Department of Laboratory Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China [7] Department of Medical Oncology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China [8] Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University(Naval Medical University),Shanghai 200438,China [9] Department of Surgery,The Ohio State University,Wexner Medical Center,Columbus,OH 43215,USA [10] Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University(Naval Medical University),Shanghai 200438,China;Faculty of Medicine,the Chinese University of Hong Kong,Prince of Wales Hospital,Shatin,New Territories,Hong Kong SAR,China [11] Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University(Naval Medical University),Shanghai 200438,China;Eastern Hepatobiliary Clinical Research Institute,Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China [12] Department of Hepatobiliary and Pancreatic Surgery,General Surgery Center,First Hospital of Jilin University,Changchun 130021,China [13] Department of Hepatobiliary and Pancreatic Surgery,General Surgery Center,First Hospital of Jilin University,Changchun 130021,China;Department of Graduate,Bengbu Medical University,Bengbu 233000,China;Department of Hepatobiliary Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University(Naval Medical University),Shanghai 200438,China;Eastern Hepatobiliary Clinical Research Institute,Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China [14]
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DOI 10.1016/j.hbpd.2023.12.004
发布时间 2025-09-08(万方平台首次上网日期,不代表论文的发表时间)
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国际肝胆胰疾病杂志(英文版)

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