Clinical Value of GALAD Model on Diagnosis and Prognosis of Primary Hepatocellular Carcinoma

Objective To explore the value of GALAD（Gender,Age,Lens culinaris agglutinin-reactive AFP,AFP,Des-γ-carboxy prothrombin） model in diagnosis and prognosis of primary hepatocellular carcinoma（HCC）. Methods 98 patients with primary HCC who received radical operation from November 2016 to November 2019 in Hainan Cancer Hospital were enrolled into HCC group. At the same time, 87 patients with benign liver disease （BLD） confirmed in our hospital were enrolled into BLD group, and 86 health examinees were enrolled into control group. The levels of serum alpha fetoprotein （AFP）, alpha fetoprotein variants （AFP-L3） and des-γ-carboxy prothrombin （DCP） of all subjects were detected. The receiver operating characteristic curve （ROC） was used to analyze the diagnostic performance of single serological marker and GALAD model for HCC. The evaluation value of GALAD model in the surgical prognosis of HCC patients was analyzed. Results The area under ROC curve （AUC） of GALAD model was 0.958, higher than that of single serological marker and combined detection, the difference was statistically significant （P<0.05）. When the cutoff value was 2.75, the sensitivity, specificity and accuracy were 81.6%, 93.6% and 89.3% respectively. Kaplan-Meier survival curve analysis showed that the 3-year survival rate and median survival time of patients with high GALAD level were 23.8% and 28.03 months, distinctly lower than that of patients with low GALAD level, the 3-year survival rate and median survival time for the latter were 49.8% and 36.38 months （χ²=12.022, P=0.001）. And the 3-year progression-free survival rate and median survival time of patients with high GALAD level were 7.2% and 20.70 months, distinctly lower than that of patients with low GALAD level, the 3-year progression-free survival rate and median survival time for the latter were 46.0% and 30.32 months （χ²=9.810,P=0.002）. Conclusions GALAD model has better diagnostic performance than AFP, AFP-L3, DCP and combined detection in HCC, and has certain value in evaluating the surgical prognosis.