AUTHOR=Liu Si-Yu , Li Chao , Sun Li-Yang , Guan Ming-Cheng , Gu Li-Hui , Yin Dong-Xu , Yao Lan-Qing , Liang Lei , Wang Ming-Da , Xing Hao , Zhu Hong , Pawlik Timothy M. , Lau Wan Yee , Shen Feng , Tong Xiang-Min , Yang Tian 

TITLE=ASAP Score versus GALAD Score for detection of hepatitis C-related hepatocellular carcinoma: A multicenter case-control analysis

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1018396

DOI=10.3389/fonc.2022.1018396

ISSN=2234-943X

ABSTRACT=Background: GALAD and ASAP scores are two recently emerging statistical algorithms for estimating the likelihood of diagnosing hepatocellular carcinoma (HCC) based on gender, age, alpha-fetoprotein (AFP) and protein induced by vitamin K absence or Antagonist-II (PIVKA-II), with or without AFP-L3. We sought to compare their diagnostic performance for early detection of HCC among patients with chronic hepatitis C virus (HCV) infection in China.
Methods: In a multicenter, case-control study, we collected blood specimens from patients with HCV-HCC and age-matched controls with chronic HCV infection but without HCC. Using the area under the receiver operating characteristic curve (AUROC), the diagnostic performance of ASAP and GALAD scores were compared for detecting any stage or early-stage HCV-HCC.
Results: The study included 168 HCV-HCC cases and 193 HCV controls. ASAP score had a higher AUROC for detecting any stage HCV-HCC than GALAD score, either in the overall group (0.917 vs. 0.894, P=0.057) or the cirrhosis subgroup (0.909 vs. 0.889, P=0.132). Similar results were found for detecting early-stage HCV-HCC, either defined by the BCLC staging (stage 0-A: 0.898 vs. 0.860, P=0.026) or the 8th TNM staging (stage I: 0.899 vs. 0.870, P=0.070). In the subgroup analysis for detecting AFP-negative HCV-HCC, ASAP score also exhibit a higher AUROC than GALAD score for detecting any stage HCV-HCC (0.815 vs. 0.764, P=0.063). 
Conclusions: Compared with GALAD score, ASAP score achieved comparable even better diagnostic accuracy for early detection of HCV-HCC among Chinese patients, while had less testing costs. As such, ASAP score is more recommended than GALAD score for HCC screening and surveillance among HCV-infected patients in China.