Evaluating the GALAD Score for Detection of Hepatocellular Carcinoma in Patients With Cirrhosis.

[INTRODUCTION] Early diagnosis of hepatocellular carcinoma (HCC) is crucial but challenging, and late detection limits its treatment and prognosis. We aimed to evaluate the GALAD score as a novel yet highly accurate and promising diagnostic tool for HCC.

[METHODS] A prospective and retrospective cohort study was conducted in 196 adult patients with cirrhosis, including 102 with HCC and 94 without. The diagnostic performance of the GALAD score for HCC detection was compared with that of single biomarkers.

[RESULTS] In patients with cirrhosis with HCC, the GALAD score was 2.5 (95% CI: -2.43 to 11.09), which was significantly higher than the GALAD score of -2.46 (95% CI: -6.15 to 2.04) in patients with cirrhosis without HCC ( P <0.001). Patients with multiple tumors had a significantly higher GALAD score than those with a single tumor ( P =0.0081). There was a moderate correlation between the GALAD score and tumor size in patients with cirrhosis (r=0.44; P <0.001). The GALAD score had an area under the receiver operating characteristic curve of 0.91, higher than that of all single biomarkers used to diagnose HCC (all P <0.001). The optimal cutoff for diagnosing HCC using the GALAD score was -0.518, achieving a sensitivity of 87.25%, specificity of 82.98%, positive predictive value of 84.62%, and negative predictive value of 84.78%. At this cutoff, the GALAD score demonstrated superior sensitivity compared with single or combined biomarkers.

[CONCLUSIONS] The GALAD score shows promise in detecting HCC in patients with cirrhosis. The GALAD score could be applied in clinical practice to diagnose HCC in patients with cirrhosis, and calculating the GALAD score in clinical settings may help predict tumor size and quantity before imaging results become available.