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. 2025 Jul 1;15(1):22279.
doi: 10.1038/s41598-025-07765-1.

The role of GALAD score in the surveillance of hepatocellular carcinoma

Zülal İstemihan  1 , İbrahim Volkan Şenkal  2 , Dilan Karaca  3 , Kanan Nuriyev  2 , Aynura Rustamzade  2 , Sezen Genç Uluçeçen  2 , Gizem Dağcı  2 , Mehmet Akif Yağlı  2 , Asım Gurbanov  2 , Pelin Telli  2 , Bilger Çavuş  2 , Aslı Çifcibaşı Örmeci  2 , Filiz Akyüz  2 , Kadir Demir  2 , Fatih Beşışık  2 , Sabahattin Kaymakoğlu  2
Affiliations

The role of GALAD score in the surveillance of hepatocellular carcinoma

Zülal İstemihan et al. Sci Rep. .

Abstract

Early diagnosis of hepatocellular carcinoma (HCC) is essential in improving survival, creating a need for new markers in the early diagnosis and surveillance of HCC. This study aims to investigate the prediction of the GALAD score, which consists of gender, age, AFP, AFP-L3, and DCP, in the diagnosis of HCC in cirrhotic patients with normal AFP levels. GALAD scores were determined in 100 patients with cirrhosis and normal AFP in a tertiary center. The role of the GALAD score in the surveillance of HCC was investigated prospectively. 100 cirrhotic patients (59 male, mean age 60.4 ± 13.6 years) participated. GALAD score was higher in cases with HCC (GALAD = -0.66 in cases with HCC, and - 3.10 in cases without HCC, p < 0.001). The cut-off value of the GALAD score in the diagnosis of HCC was found to be -1.93 according to ROC analysis (AUC of 0.798, 95% CI: 70.5-89.1, sensitivity = 71%, specificity = 71%). In regression analysis, the risk of developing HCC was 3.4 times higher in patients with a GALAD score ≥ -1.93. The GALAD score is an important marker for the surveillance of HCC in cirrhotic patients with normal AFP.

Keywords: AFP; GALAD score; Hepatocellular carcinoma; Surveillance.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
GALAD score cut-off, sensitivity, and specificity for HCC according to ROC analysis.
Fig. 2
Fig. 2
Kaplan–Meier curves for cumulative HCC of patients with GALAD score < −1.93 and ≥ −1.93.
See this image and copyright information in PMC

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