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AASLD 2022: Comparing Performance of Blood Tests in Early-Stage Hepatocellular Carcinoma

By: Emily Rhode
Posted: Friday, November 11, 2022

Presented at the 2022 American Association for the Study of Liver Diseases (AASLD) Annual Meeting (Abstract 5028), a post hoc analysis suggests that the multitarget hepatocellular carcinoma blood test (mt-HBT) may be an accurate and effective surveillance modality for the detection of early-stage hepatocellular carcinoma. Naga P. Chalasani, MD, of Indiana University of Medicine, Indianapolis, and colleagues compared early-stage hepatocellular sensitivity over an array of specificities using both current screening tests and mt-HBT.

“High early-stage hepatocellular carcinoma sensitivity was observed with mt-HBT cutoff values corresponding to a wide range of specificity. The mt-HBT provides consistent performance over a range of specificity values,” concluded the study authors.

The study evaluated a total of 156 patients with treatment-naive hepatocellular carcinoma, 78 of whom were classified as having early-stage disease, and 245 patients with chronic liver disease who were confirmed to be at risk for hepatocellular carcinoma but did not have the disease. The researchers compared early-stage sensitivity of mt-HBT; gender, age, AFP-L3, AFP, and DCP model (GALAD); and alpha-fetoprotein tumor marker tests across cutoffs that correlated to matched specificities with a range of 80% to 95%.

At 80% specificity, the early-stage sensitivity of mt-HBT was 85% (95% confidence interval [CI] = 75%–91%), and 95% specificity yielded a sensitivity of 72% (95% CI = 61%–81%). Specificities of 80% to 95% correlated to early-stage sensitivities of 83% to 69% for GALAD and 69% to 54% for alpha-fetoprotein, respectively. Of note, the early-stage sensitivity of mt-HBT of 82% did not change when the mt-HBT cutoff for 87% specificity was increased to the specificity cutoff corresponding to 90%. The authors also observed that as specificity increased from 85% to 90%, GALAD and alpha-fetoprotein sensitivities decreased by 5% and 9%, respectively, whereas mt-HBT sensitivity decreased by 1%.

Disclosure: To view Dr. Chalasani’s disclosures, visit aasld.org.


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