Clinical and Experimental Hepatology
eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications
1/2025
vol. 11
 
Share:
Send email
Share:
abstract:
Original paper

The GALAD score performs better than AFP in hepatocellular carcinoma screening: a single-centre, case-control study in Malaysia

Wing Hang Woo
1
,
Khairul Najmi Muhammad Nawawi
1
,
Deborah Chia Hsin Chew
1, 2
,
Wei Hao Kok
1
,
Zhiqin Wong
3
,
Azlanudin Azman
4
,
Nur Yazmin Yaacob
5
,
Munirah Md Mansor
6
,
Hanita Othman
6
,
Raja Affendi Raja Ali
2, 7

  1. Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
  2. GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
  3. Pantai Hospital Kuala Lumpur, Malaysia
  4. Hepatobiliary Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
  5. Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
  6. Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
  7. School of Medical and Life Sciences, Sunway University, Petaling Jaya, Selangor, Malaysia
Clin Exp HEPATOL 2025; 11, 1: 81-87
DOI: https://doi.org/10.5114/ceh.2025.148321
Online publish date: 2025/03/25
View full text Get citation
 
PlumX metrics:
Aim of the study:
Hepatocellular carcinoma (HCC) in Malaysia is a growing health concern, despite regular liver ultrasound and a-fetoprotein (AFP) surveillance. The GALAD model incorporates AFP, lens culinaris agglutinin-reactive a-fetoprotein (AFP-L3), protein induced by vitamin K antagonist-II (PIVKA-II), gender and age to predict the probability of HCC. Our objective was to evaluate the diagnostic ability of GALAD compared to AFP in HCC screening.

Material and methods:
A single-centre, case control study recruited newly diagnosed HCC and cirrhotic patients. Serum biomarkers were quantified using a microfluidic-based automated immunoanalyzer. The diagnostic ability of AFP, AFP-L3, PIVKA-II and GALAD was assessed using receiver operating characteristic curve (ROC) and corresponding area under the curve (AUC) analysis.

Results:
Among the 44 HCC cases, GALAD score achieved the highest AUC value of 0.94 (95% confidence interval [CI]: 0.90-0.98, p < 0.0001) significantly surpassing AFP (0.89), AFP-L3 (0.84) and PIVKA-II (0.88). The GALAD score demonstrated 84.1% sensitivity and 93.8% specificity at the standard cut-off (–0.63) and 88.6%/92.2% at its best cut-off (–1.035) for detecting any stage of HCC, outperforming AFP (79.5%/92.2%), AFP-L3 (59.1%/94.9%) and PIVKA-II (79.5%/84.9%). The sensitivity of the GALAD score was 100% in earlystage HCC (BCLC0/A).

Conclusions:
GALAD outperformed conventional biomarkers, facilitating early detection, improved treatment options and ultimately a higher survival rate for HCC patients.

keywords:

HCC, AFP, GALAD
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2025 Termedia Sp. z o.o.
Developed by Bentus.