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Abstract：
OBJECTIVE: The GALAD score and the BALAD-2 score are biomarker-based scoring systems used to detect hepatocellular carcinoma (HCC). Both incorporate levels of alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). Our objective was to examine the relationship between the GALAD score as well as the BALAD-2 score and treatment response to transarterial or systemic treatments in patients with HCC.
METHODS: A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria.
RESULTS: The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP.
CONCLUSIONS: The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.
METHODS: A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria.
RESULTS: The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP.
CONCLUSIONS: The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.
摘要：
目的：GALAD评分和BALAD-2评分是用于检测肝细胞癌（HCC）的基于生物标志物的评分系统。两者都含有甲胎蛋白（AFP）的水平，角膜晶状体凝集素反应性AFP（AFP-L3），和des-γ-羧基凝血酶原(DCP)。我们的目标是检查GALAD评分以及BALAD-2评分与HCC患者经动脉或全身治疗的治疗反应之间的关系。
方法：回顾性分析了220例经动脉（n=121）或全身治疗（n=99；主要是索拉非尼）的HCC患者。根据AFP-L3、AFP、和在治疗前收集的血清样品中测量的DCP水平。根据放射学mRECIST标准，结果与3个月的治疗效果相关。
结果：GALAD评分与治疗前的BCLC分期（p<0.001）和肿瘤总直径（p<0.001）有很强的相关性。基线时的GALAD评分在对动脉有3个月反应的患者中显著低于难治性患者(p>0.001)。在接受全身治疗的患者中，基线时的中位BALAD-2评分与第3个月时的缓解率密切相关(p<0.001).在经动脉治疗组中，GALAD评分（AUC=0.715;p<0.001）和BALAD评分（AUC=0.696;p<0.001）与总生存率相关，因此表现优于法新社，AFP-L3和DCP。
结论：GALAD评分和BALAD-2评分作为早期或中期HCC患者经动脉或全身治疗的预后工具具有重要意义。
方法：回顾性分析了220例经动脉（n=121）或全身治疗（n=99；主要是索拉非尼）的HCC患者。根据AFP-L3、AFP、和在治疗前收集的血清样品中测量的DCP水平。根据放射学mRECIST标准，结果与3个月的治疗效果相关。
结果：GALAD评分与治疗前的BCLC分期（p<0.001）和肿瘤总直径（p<0.001）有很强的相关性。基线时的GALAD评分在对动脉有3个月反应的患者中显著低于难治性患者(p>0.001)。在接受全身治疗的患者中，基线时的中位BALAD-2评分与第3个月时的缓解率密切相关(p<0.001).在经动脉治疗组中，GALAD评分（AUC=0.715;p<0.001）和BALAD评分（AUC=0.696;p<0.001）与总生存率相关，因此表现优于法新社，AFP-L3和DCP。
结论：GALAD评分和BALAD-2评分作为早期或中期HCC患者经动脉或全身治疗的预后工具具有重要意义。
