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. NguyenAlex 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

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: The GALAD score is a serum biomarker–sensitivity of 91% and a specificity of 85% for HCC detection. based model that predicts the probability of having The AUC of the GALAD score for early-stage HCC detection hepatocellular carcinoma (HCC) in patients with chronic remained high at 0.92 (95% CI, 0.88–0.96; cutoff 1.18, liver disease. We aimed to assess the performance of the sensitivity 92%, specificity 79%). The AUC of the GALAD GALAD score in comparison with liver ultrasound for score for HCC detection was 0.88 (95% CI, 0.85–0.91) in the detection of HCC. EDRN cohort. The combination of GALAD and ultrasound Methods: A single-center cohort of 111 HCC patients and (GALADUS score) further improved the performance of the 180 controls with cirrhosis or chronic hepatitis B and a GALAD score in the single-center cohort, achieving an AUC multicenter cohort of 233 early HCC and 412 cirrhosis of 0.98 (95% CI, 0.96–0.99; cutoff 0.18, sensitivity 95%, patients from the Early Detection Research Network (EDRN) specificity 91%). phase II HCC Study were analyzed. Conclusions: The performance of the GALAD score was Results: The area under the ROC curve (AUC) of the GALAD superior to ultrasound for HCC detection. The GALADUS score for HCC detection was 0.95 [95% confidence interval score further enhanced the performance of the GALAD score. (CI), 0.93–97], which was higher than the AUC of ultrasound Impact: The GALAD score was validated in the United (0.82, P <0.01). At a cutoff of 0.76, the GALAD score had a States.

Original languageEnglish (US)
Pages (from-to)531-538
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Issue number3
StatePublished - Mar 2019
Externally publishedYes

Bibliographical note

Funding Information:
This publication was supported by grant number T32 DK07198 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; to J.D. Yang) and CA165076 from the NCI, the Mayo Clinic Center for Cell Signaling in Gastroenterology (NIDDK P30DK084567), the Mayo Clinic Cancer Center (CA15083), the Mayo Clinic Center for Translational Science Activities (NIH/NCRR CTSA grant number UL1 TR000135, to L.R. Roberts), and the Early Detection Research Network (NCI U24CA086368). Biomarker assays were performed by Wako Diagnostics.

Funding Information:
M.H. Nguyen reports receiving commercial research support from Bristol-Myers Squibb, Janssen Pharmaceuticals, Gilead Sciences, Laboratory for Advanced Medicine, and Exact Science; received honoraria from the speakers'

Publisher Copyright:
© 2018 American Association for Cancer Research.


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