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<p>This study explores new screening strategies to enhance liver cancer screening effectiveness. In a prospective study, 2605 participants underwent baseline, 6-months self-reported, and 1-year follow-up screenings using abdominal ultrasonography, AFP, AFP-L3%, and DCP. The results demonstrated the GALADUS protocol exhibited superior performance with higher AUC (0.935 vs. 0.836; DeLong <i>P</i> &lt; 0.001), sensitivity (91.0% vs. 70.8%; <i>P</i> &lt; 0.001), detection (3.1% vs. 2.4%; <i>P</i> &lt; 0.001), and early diagnosis rates (64.2% vs. 58.7%) compared to the AFP/US protocol. Notably, among individuals with an aMAP score ≥ 60, GALADUS had significantly outperformed AFP/US in AUC (0.923 vs. 0.826; DeLong <i>P</i> &lt; 0.001), sensitivity (94.2% vs. 69.6%; <i>P</i> &lt; 0.001), detection (9.7% vs. 7.2%; <i>P</i> &lt; 0.001), and early diagnosis rates (63.1% vs. 54.2%). However, for those with an aMAP score &lt; 60, GALADUS offered no significant advantages. Introducing the “aMAP triage” protocol, combining GALADUS for aMAP ≥ 60 and AFP/US for aMAP &lt; 60, further enhanced AUC to 0.925 (DeLong <i>P</i> &lt; 0.001), improved sensitivity by 19.1% (89.9% vs. 70.8%; <i>P</i> &lt; 0.001), and increased detection (3.1% vs. 2.4%; <i>P</i> &lt; 0.001) and early diagnosis rates (65.0% vs. 58.7%), being cost-effective compared to GALADUS. In conclusion, this study highlights the potential of a stratified precision screening strategy in identifying high-risk individuals, applying tailored early detection protocols to improve liver cancer screening efficacy.</p>

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A stratified precision screening strategy for enhancing hepatitis B- and C-associated liver cancer detection: a prospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月3日

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  • Hua He,
  • Yanhua Wu,
  • Zhifang Jia,
  • Yangyu Zhang,
  • Yuchen Pan,
  • Yuzheng Zhang,
  • Kaisheng Su,
  • Yingnan Cui,
  • Yuanlin Sun,
  • Dongming Li,
  • Haiyong Lv,
  • Jiaxin Yi,
  • Yuehui Wang,
  • Changgui Kou,
  • Xiaofeng Sun,
  • Jing Jiang

摘要

This study explores new screening strategies to enhance liver cancer screening effectiveness. In a prospective study, 2605 participants underwent baseline, 6-months self-reported, and 1-year follow-up screenings using abdominal ultrasonography, AFP, AFP-L3%, and DCP. The results demonstrated the GALADUS protocol exhibited superior performance with higher AUC (0.935 vs. 0.836; DeLong P < 0.001), sensitivity (91.0% vs. 70.8%; P < 0.001), detection (3.1% vs. 2.4%; P < 0.001), and early diagnosis rates (64.2% vs. 58.7%) compared to the AFP/US protocol. Notably, among individuals with an aMAP score ≥ 60, GALADUS had significantly outperformed AFP/US in AUC (0.923 vs. 0.826; DeLong P < 0.001), sensitivity (94.2% vs. 69.6%; P < 0.001), detection (9.7% vs. 7.2%; P < 0.001), and early diagnosis rates (63.1% vs. 54.2%). However, for those with an aMAP score < 60, GALADUS offered no significant advantages. Introducing the “aMAP triage” protocol, combining GALADUS for aMAP ≥ 60 and AFP/US for aMAP < 60, further enhanced AUC to 0.925 (DeLong P < 0.001), improved sensitivity by 19.1% (89.9% vs. 70.8%; P < 0.001), and increased detection (3.1% vs. 2.4%; P < 0.001) and early diagnosis rates (65.0% vs. 58.7%), being cost-effective compared to GALADUS. In conclusion, this study highlights the potential of a stratified precision screening strategy in identifying high-risk individuals, applying tailored early detection protocols to improve liver cancer screening efficacy.