Comparison of diagnostic performance of GAAD, GALAD, and ASAP scores for detecting hepatocellular carcinoma in advanced liver fibrosis patients

Objectives Alpha-fetoprotein L3 (AFP-L3 %) and protein induced by vitamin K absence-II (PIVKA-II) are used in diagnostic scores such as GAAD, GALAD, and ASAP for hepatocellular carcinoma (HCC) detection. Advanced liver fibrosis (ALF) is diagnosable by the liver fibrosis index and could be combined w...

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Detalles Bibliográficos
Autores: Izquierdo-Martínez, Alberto, Rojas, Ángela, Rubio-Sánchez, Ricardo, Dominguez-Pascual, Inmaculada, Romero Gómez, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/182411
Acceso en línea:https://hdl.handle.net/11441/182411
https://doi.org/10.1515/almed-2025-0144
Access Level:acceso abierto
Palabra clave:Hepatocellular carcinoma
Liver fibrosis
GAAD score
GALAD score
ASAP score
Fatty liver disease
Descripción
Sumario:Objectives Alpha-fetoprotein L3 (AFP-L3 %) and protein induced by vitamin K absence-II (PIVKA-II) are used in diagnostic scores such as GAAD, GALAD, and ASAP for hepatocellular carcinoma (HCC) detection. Advanced liver fibrosis (ALF) is diagnosable by the liver fibrosis index and could be combined with these blood biomarkers for better HCC detection. Methods This study developed an analytical framework to address the role of GAAD, GALAD, and ASAP in ALF patients as a risk score to predict HCC. By analyzing data from 21 HCC and 30 ALF patients, this analysis assessed the diagnostic accuracy of individual biomarkers, ASAP, GAAD, and GALAD. Results GAAD slightly outperformed AFP (sensitivity: 76.2 %, specificity: 88.5 %). The combination of AFP and PIVKA-II also surpassed AFP alone. PIVKA-II and AFP-L3 showed the worst performance for identifying HCC. Conclusions GAAD and ASAP showed comparable or slightly superior performance to AFP, suggesting potential for screening strategies that should be confirmed in larger studies.