GALAD Model for Hepatocellular Carcinoma (HCC)
Understanding the GALAD Model
The GALAD model is a validated scoring system that calculates the probability of hepatocellular carcinoma (HCC) in patients with chronic liver disease. It combines Gender, Age, and three serum biomarkers: AFP-L3, AFP, and DCP (PIVKA-II). The model has shown excellent diagnostic accuracy with AUROC of 0.97-0.98 in validation studies.
Clinical Performance
The model has demonstrated:
- Sensitivity up to 97% when optimized for maximum sensitivity
- Specificity up to 97% when optimized for maximum specificity
- Overall accuracy of 88-91% in correct classification
- Strong performance in both early and late stage HCC
Clinical Applications
The GALAD model is particularly useful for:
- Screening high-risk patients with chronic liver disease
- Early detection of HCC
- Enhancing ultrasound screening effectiveness
- Risk assessment in surveillance programs
Factors Affecting Biomarkers
AFP and AFP-L3 can be affected by
- Liver inflammation
- Pregnancy
- Certain medications
- Other liver conditions
DCP can be affected by
- Vitamin K deficiency
- Anticoagulation therapy
- Liver dysfunction
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