28. The value of the gaad algorithm in the clinical performance of hepatocellular carcinoma screening in chronic hepatitis B patients with AFP <20ng/ml
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Abstract
A cross-sectional descriptive study was conducted to evaluate the diagnostic performance of hepatocellular carcinoma (UTBMTBG) in high-risk patients with chronic hepatitis B infection (VGBM); patients were routinely monitored with a negative AFP (< 20 ng/ml) using the GAAD score. The study was conducted using retrospective and prospective methods on 225 chronic hepatitis B patients with AFP < 20 ng/mL, based on the AFP and PIVKA-II tests obtained from January 2022 to July 2024 at the National Hospital of Tropical Diseases. The findings revealed that the GAAD exhibits a higher sensitivity than single AFP and PIVKA II in the differential diagnosis of UTBMTBG. The AUC of GAAD was 0.854 (95% CI: 0.800-0.907) higher than PIVKA II, which was 0.800 (95% CI: 0.737-0.862). The optimal cut-off of GAAD was 1.9, with a sensitivity of 86.3% and a specificity of 75.7%. The GAAD score could be a potential index to induce the sensitivity of early HCC screening for chronic hepatitis B patients, especially in patients with negative AFP and PIVKA-II.
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Keywords
Hepatocellular carcinoma, chronic hepatitis B infection, PIVKA-II, AFP, GAAD
References
2. Easterbrook PJ, Luhmann N, Bajis S, et al. WHO 2024 hepatitis B guidelines: an opportunity to transform care. The lancet Gastroenterology & hepatology. Jun 2024; 9(6): 493-495. doi:10,1016/s2468-1253(24)00089-x.
3. Piratvisuth T, Hou J, Tanwandee T, et al. Development and clinical validation of a novel algorithmic score (GAAD) for detecting HCC in prospective cohort studies. Hepatology communications. Nov 1 2023; 7(11)doi:10,1097/hc9.0000000000000317.
4. Wen N, Cai Y, Li F, et al. The clinical management of hepatocellular carcinoma worldwide: A concise review and comparison of current guidelines: 2022 update. Bioscience trends. Mar 11 2022; 16(1): 20-30, doi:10,5582/bst.2022.01061.
5. Bộ Y tế. Hướng dẫn chẩn đoán và điều trị ung thư biểu mô tế bào gan. Quyết định số 3129/QĐ-BYT ngày 17 tháng 07 năm 2020,
6. Johnson PJ, Pirrie SJ, Cox TF, et al. The detection of hepatocellular carcinoma using a prospectively developed and validated model based on serological biomarkers. Cancer Epidemiol Biomarkers Prev. Jan 2014; 23(1): 144-53. doi:10,1158/1055-9965.EPI-13-0870.
7. Henry Lik-Yuen Chan AV, Thomas Berg, Enrico N De Toni, Masatoshi Kudo, Jörg Trojan, Katharina Malinowsky, Peter Findeisen, Hanns-Georg Klein, Johannes Kolja Hegel, Wenzel Schöning, Konstantin Kröniger, Kairat Madin, Ashish Sharma, Teerha Piratvisuth. A comparative analysis of Elecsys GALAD and Elecsys GAAD score to detect early-stage hepatocellular carcinoma in an international cohort. EASL ILC International Liver Congress22–26 June, 2022.
8. Tzartzeva K, Obi J, Rich NE, et al. Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis. Gastroenterology. May 2018; 154(6): 1706-1718.e1. doi:10,1053/j.gastro.2018.01.064.
9. Kudo M. Management of Hepatocellular Carcinoma in Japan as a World-Leading Model. Liver cancer. May 2018; 7(2): 134-147. doi:10,1159/000484619.