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GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis

Standard

GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis. / Best, Jan; Bechmann, Lars P; Sowa, Jan-Peter; Sydor, Svenja; Dechêne, Alexander; Pflanz, Kristina; Bedreli, Sotiria; Schotten, Clemens; Geier, Andreas; Berg, Thomas; Fischer, Janett; Vogel, Arndt; Bantel, Heike; Weinmann, Arndt; Schattenberg, Jörn M; Huber, Yvonne; Wege, Henning; von Felden, Johann; Schulze, Kornelius; Bettinger, Dominik; Thimme, Robert; Sinner, Friedrich; Schütte, Kerstin; Weiss, Karl Heinz; Toyoda, Hidenori; Yasuda, Satoshi; Kumada, Takashi; Berhane, Sarah; Wichert, Marc; Heider, Dominik; Gerken, Guido; Johnson, Philip; Canbay, Ali.

in: CLIN GASTROENTEROL H, Jahrgang 18, Nr. 3, 03.2020, S. 728-735.e4.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Best, J, Bechmann, LP, Sowa, J-P, Sydor, S, Dechêne, A, Pflanz, K, Bedreli, S, Schotten, C, Geier, A, Berg, T, Fischer, J, Vogel, A, Bantel, H, Weinmann, A, Schattenberg, JM, Huber, Y, Wege, H, von Felden, J, Schulze, K, Bettinger, D, Thimme, R, Sinner, F, Schütte, K, Weiss, KH, Toyoda, H, Yasuda, S, Kumada, T, Berhane, S, Wichert, M, Heider, D, Gerken, G, Johnson, P & Canbay, A 2020, 'GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis', CLIN GASTROENTEROL H, Jg. 18, Nr. 3, S. 728-735.e4. https://doi.org/10.1016/j.cgh.2019.11.012

APA

Best, J., Bechmann, L. P., Sowa, J-P., Sydor, S., Dechêne, A., Pflanz, K., Bedreli, S., Schotten, C., Geier, A., Berg, T., Fischer, J., Vogel, A., Bantel, H., Weinmann, A., Schattenberg, J. M., Huber, Y., Wege, H., von Felden, J., Schulze, K., ... Canbay, A. (2020). GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis. CLIN GASTROENTEROL H, 18(3), 728-735.e4. https://doi.org/10.1016/j.cgh.2019.11.012

Vancouver

Best J, Bechmann LP, Sowa J-P, Sydor S, Dechêne A, Pflanz K et al. GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis. CLIN GASTROENTEROL H. 2020 Mär;18(3):728-735.e4. https://doi.org/10.1016/j.cgh.2019.11.012

Bibtex

@article{9021e96db0124af3bb1cb77be9b51a9e,
title = "GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis",
abstract = "BACKGROUND & AIMS: The prevalence of nonalcoholic steatohepatitis (NASH) associated hepatocellular carcinoma (HCC) is increasing. However, strategies for detection of early-stage HCC in patients with NASH have limitations. We assessed the ability of the GALAD score, which determines risk of HCC based on patient sex; age; and serum levels of α-fetoprotein (AFP), AFP isoform L3 (AFP-L3), and des-gamma-carboxy prothrombin (DCP), to detect HCC in patients with NASH.METHODS: We performed a case-control study of 125 patients with HCC (20% within Milan Criteria) and 231 patients without HCC (NASH controls) from 8 centers in Germany. We compared the performance of serum AFP, AFP-L3, or DCP vs GALAD score to identify patients with HCC using receiver operating characteristic curves and corresponding area under the curve (AUC) analyses. We also analyzed data from 389 patients with NASH under surveillance for HCC in Japan, followed for a median of 167 months. During the 5-year screening period, 26 patients developed HCC. To compensate for irregular intervals of data points, we performed locally weighted scatterplot smoothing, linear regression, and a non-linear curve fit to assess development of GALAD before HCC development.RESULTS: The GALAD score identified patients with any stage HCC with an AUC of 0.96 - significantly greater than values for serum levels of AFP (AUC, 0.88), AFP-L3 (AUC, 0.86) or DCP (AUC, 0.87). AUC values for the GALAD score were consistent in patients with cirrhosis (AUC, 0.93) and without cirrhosis (AUC, 0.98). For detection of HCC within Milan Criteria, the GALAD score achieved an AUC of 0.91, with a sensitivity of 68% and specificity of 95% at a cutoff of -0.63. In a pilot Japanese cohort study, the mean GALAD score was higher in patients with NASH who developed HCC than in those who did not develop HCC as early as 1.5 years before HCC diagnosis. GALAD scores were above -0.63 approximately 200 days before the diagnosis of HCC.CONCLUSIONS: In a case-control study performed in Germany and a pilot cohort study in Japan, we found the GALAD score may detect HCC with high levels of accuracy in patients with NASH, with and without cirrhosis. The GALAD score can detect patients with early-stage HCC, and might facilitate surveillance of patients with NASH, who are often obese, which limits the sensitivity of detection of liver cancer by ultrasound.",
author = "Jan Best and Bechmann, {Lars P} and Jan-Peter Sowa and Svenja Sydor and Alexander Dech{\^e}ne and Kristina Pflanz and Sotiria Bedreli and Clemens Schotten and Andreas Geier and Thomas Berg and Janett Fischer and Arndt Vogel and Heike Bantel and Arndt Weinmann and Schattenberg, {J{\"o}rn M} and Yvonne Huber and Henning Wege and {von Felden}, Johann and Kornelius Schulze and Dominik Bettinger and Robert Thimme and Friedrich Sinner and Kerstin Sch{\"u}tte and Weiss, {Karl Heinz} and Hidenori Toyoda and Satoshi Yasuda and Takashi Kumada and Sarah Berhane and Marc Wichert and Dominik Heider and Guido Gerken and Philip Johnson and Ali Canbay",
note = "Copyright {\textcopyright} 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.",
year = "2020",
month = mar,
doi = "10.1016/j.cgh.2019.11.012",
language = "English",
volume = "18",
pages = "728--735.e4",
journal = "CLIN GASTROENTEROL H",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis

AU - Best, Jan

AU - Bechmann, Lars P

AU - Sowa, Jan-Peter

AU - Sydor, Svenja

AU - Dechêne, Alexander

AU - Pflanz, Kristina

AU - Bedreli, Sotiria

AU - Schotten, Clemens

AU - Geier, Andreas

AU - Berg, Thomas

AU - Fischer, Janett

AU - Vogel, Arndt

AU - Bantel, Heike

AU - Weinmann, Arndt

AU - Schattenberg, Jörn M

AU - Huber, Yvonne

AU - Wege, Henning

AU - von Felden, Johann

AU - Schulze, Kornelius

AU - Bettinger, Dominik

AU - Thimme, Robert

AU - Sinner, Friedrich

AU - Schütte, Kerstin

AU - Weiss, Karl Heinz

AU - Toyoda, Hidenori

AU - Yasuda, Satoshi

AU - Kumada, Takashi

AU - Berhane, Sarah

AU - Wichert, Marc

AU - Heider, Dominik

AU - Gerken, Guido

AU - Johnson, Philip

AU - Canbay, Ali

N1 - Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND & AIMS: The prevalence of nonalcoholic steatohepatitis (NASH) associated hepatocellular carcinoma (HCC) is increasing. However, strategies for detection of early-stage HCC in patients with NASH have limitations. We assessed the ability of the GALAD score, which determines risk of HCC based on patient sex; age; and serum levels of α-fetoprotein (AFP), AFP isoform L3 (AFP-L3), and des-gamma-carboxy prothrombin (DCP), to detect HCC in patients with NASH.METHODS: We performed a case-control study of 125 patients with HCC (20% within Milan Criteria) and 231 patients without HCC (NASH controls) from 8 centers in Germany. We compared the performance of serum AFP, AFP-L3, or DCP vs GALAD score to identify patients with HCC using receiver operating characteristic curves and corresponding area under the curve (AUC) analyses. We also analyzed data from 389 patients with NASH under surveillance for HCC in Japan, followed for a median of 167 months. During the 5-year screening period, 26 patients developed HCC. To compensate for irregular intervals of data points, we performed locally weighted scatterplot smoothing, linear regression, and a non-linear curve fit to assess development of GALAD before HCC development.RESULTS: The GALAD score identified patients with any stage HCC with an AUC of 0.96 - significantly greater than values for serum levels of AFP (AUC, 0.88), AFP-L3 (AUC, 0.86) or DCP (AUC, 0.87). AUC values for the GALAD score were consistent in patients with cirrhosis (AUC, 0.93) and without cirrhosis (AUC, 0.98). For detection of HCC within Milan Criteria, the GALAD score achieved an AUC of 0.91, with a sensitivity of 68% and specificity of 95% at a cutoff of -0.63. In a pilot Japanese cohort study, the mean GALAD score was higher in patients with NASH who developed HCC than in those who did not develop HCC as early as 1.5 years before HCC diagnosis. GALAD scores were above -0.63 approximately 200 days before the diagnosis of HCC.CONCLUSIONS: In a case-control study performed in Germany and a pilot cohort study in Japan, we found the GALAD score may detect HCC with high levels of accuracy in patients with NASH, with and without cirrhosis. The GALAD score can detect patients with early-stage HCC, and might facilitate surveillance of patients with NASH, who are often obese, which limits the sensitivity of detection of liver cancer by ultrasound.

AB - BACKGROUND & AIMS: The prevalence of nonalcoholic steatohepatitis (NASH) associated hepatocellular carcinoma (HCC) is increasing. However, strategies for detection of early-stage HCC in patients with NASH have limitations. We assessed the ability of the GALAD score, which determines risk of HCC based on patient sex; age; and serum levels of α-fetoprotein (AFP), AFP isoform L3 (AFP-L3), and des-gamma-carboxy prothrombin (DCP), to detect HCC in patients with NASH.METHODS: We performed a case-control study of 125 patients with HCC (20% within Milan Criteria) and 231 patients without HCC (NASH controls) from 8 centers in Germany. We compared the performance of serum AFP, AFP-L3, or DCP vs GALAD score to identify patients with HCC using receiver operating characteristic curves and corresponding area under the curve (AUC) analyses. We also analyzed data from 389 patients with NASH under surveillance for HCC in Japan, followed for a median of 167 months. During the 5-year screening period, 26 patients developed HCC. To compensate for irregular intervals of data points, we performed locally weighted scatterplot smoothing, linear regression, and a non-linear curve fit to assess development of GALAD before HCC development.RESULTS: The GALAD score identified patients with any stage HCC with an AUC of 0.96 - significantly greater than values for serum levels of AFP (AUC, 0.88), AFP-L3 (AUC, 0.86) or DCP (AUC, 0.87). AUC values for the GALAD score were consistent in patients with cirrhosis (AUC, 0.93) and without cirrhosis (AUC, 0.98). For detection of HCC within Milan Criteria, the GALAD score achieved an AUC of 0.91, with a sensitivity of 68% and specificity of 95% at a cutoff of -0.63. In a pilot Japanese cohort study, the mean GALAD score was higher in patients with NASH who developed HCC than in those who did not develop HCC as early as 1.5 years before HCC diagnosis. GALAD scores were above -0.63 approximately 200 days before the diagnosis of HCC.CONCLUSIONS: In a case-control study performed in Germany and a pilot cohort study in Japan, we found the GALAD score may detect HCC with high levels of accuracy in patients with NASH, with and without cirrhosis. The GALAD score can detect patients with early-stage HCC, and might facilitate surveillance of patients with NASH, who are often obese, which limits the sensitivity of detection of liver cancer by ultrasound.

U2 - 10.1016/j.cgh.2019.11.012

DO - 10.1016/j.cgh.2019.11.012

M3 - SCORING: Journal article

C2 - 31712073

VL - 18

SP - 728-735.e4

JO - CLIN GASTROENTEROL H

JF - CLIN GASTROENTEROL H

SN - 1542-3565

IS - 3

ER -