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Serum-biomarker-based population screening model for hepatocellular carcinoma
Wenmin Liao1,2, Wenbin Lin3, Zhonglian He1,2
1State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, P.R. China.
Iscience
|March 10, 2025
Summary
A new, cost-effective screening model for hepatocellular carcinoma (HCC) uses serum markers for early detection. This simplified approach improves accuracy and risk assessment, offering a vital public health tool.
Area of Science:
- Hepatology
- Oncology
- Biomarker Discovery
Background:
- Early identification of hepatocellular carcinoma (HCC) is critical for patient survival.
- Existing screening methods for HCC are often complex and expensive, limiting widespread adoption.
- There is a need for accessible and cost-effective tools for early HCC detection.
Purpose of the Study:
- To develop and validate a simplified, cost-effective two-stage screening model for early hepatocellular carcinoma (HCC) detection using serum markers.
- To evaluate the performance of the proposed model in diverse patient populations.
- To compare the efficacy of the new model against traditional screening methods, such as alpha-fetoprotein (AFP) alone.
Main Methods:
- Recruitment of a diverse study population from two Chinese hospitals, including cancer patients, hospital patients, and healthy individuals.
- Development of a two-stage screening strategy: preliminary screening using LASSO logistic regression, followed by a second stage incorporating alpha-fetoprotein (AFP).
- Rigorous performance evaluation across multiple cohorts using metrics such as AUC-ROC, accuracy, sensitivity, and specificity.
Main Results:
- The developed two-stage model demonstrated robust performance across five populations, with AUC-ROC values ranging from 0.868 to 0.907.
- High accuracy (87.43%–96.96%), sensitivity (>75%), and specificity (>90%) were achieved.
- The second-stage model significantly improved HCC risk stratification in healthy populations compared to AFP alone, showing higher AUC (0.930 vs. 0.827) and substantial Net Reclassification Improvement (NRI) up to 56.2%.
Conclusions:
- The proposed two-stage HCC screening model is a practical and cost-efficient tool for early detection.
- This simplified model enhances risk assessment, particularly in healthy individuals, addressing a significant public health challenge.
- The model's strong performance and cost-effectiveness make it a valuable addition to current HCC screening strategies.
