Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers
Background & Aims: Previously proposed staging systems for hepatocellular carcinoma (HCC) involve clinical, imaging, or pathologic factors in the evaluation. We established and validated a novel staging system for HCC that is based on simply serum markers. Methods: The new scoring system is base...
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| Veröffentlicht in: | Clinical gastroenterology and hepatology 2006-12, Vol.4 (12), p.1528-1536 |
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| creator | Toyoda, Hidenori Kumada, Takashi Osaki, Yukio Oka, Hiroko Urano, Fumihiro Kudo, Masatoshi Matsunaga, Takashi |
| description | Background & Aims:
Previously proposed staging systems for hepatocellular carcinoma (HCC) involve clinical, imaging, or pathologic factors in the evaluation. We established and validated a novel staging system for HCC that is based on simply serum markers.
Methods:
The new scoring system is based on 5 serum markers: bilirubin, albumin,
Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3), α-fetoprotein (AFP), and des-γ-carboxy prothrombin (DCP) and thus is termed the BALAD score. The system was validated in 2600 HCC patients from 5 institutions. The power of our system to predict patient survival and its discriminative ability were compared with those of previously reported staging systems.
Results:
The best tumor marker cutoff values were 400 ng/dL for AFP, 15% for AFP-L3, and 100 milli-arbitrary unit/mL for DCP. The patients were classified into 6 categories on the basis of 5 laboratory values. The categories reflected patient survival well. The discriminative ability was comparable to that of previously reported staging systems.
Conclusions:
The new staging system for HCC combining serum albumin, serum bilirubin, and 3 tumor markers predicts patient outcomes with excellent discriminative ability. The system is easy to use and objective. In addition, stage can be evaluated with the use of only 1 serum sample. It also allows global comparison of patients with HCC or comparison of patients from different time periods with the same standard. |
| doi_str_mv | 10.1016/j.cgh.2006.09.021 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68237340</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1542356506009499</els_id><sourcerecordid>68237340</sourcerecordid><originalsourceid>FETCH-LOGICAL-c417t-4a0872e129ecc7982ad7bb0c458149d88dd4a68952a4f3a638924f4397a6f5273</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0E4v0BbJBXCBYNtuPEsVi15SkVWBTW1tSZlJQkLnaC1L8npZXYsZrR6NwrzSHkjLOIM55eLyI7_4gEY2nEdMQE3yGHPJFioBSXu9s9TtLkgByFsGBMaKnVPjngiqdCSHlIzLSFednM6SMuoXUWq6qrwNMxeFs2rgY6W1GgL-4bKzq1zq_Z6Sq0WNPL0XAyvP294hUdQcCcuoZO0Xc1fQb_iT6ckL0CqoCn23lM3u_v3saPg8nrw9N4OBlYyVU7kMAyJZALjdYqnQnI1WzGrEwyLnWeZXkuIc10IkAWMaRxpoUsZKwVpEUiVHxMLja9S---Ogytqcuw_gYadF0waSZiFUvWg3wDWu9C8FiYpS9r8CvDmVlbNQvTWzVrq4Zp01vtM-fb8m5WY_6X2GrsgZsNgP2L3yV6E2yJjcW89Ghbk7vyn_of1VCF0Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68237340</pqid></control><display><type>article</type><title>Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Toyoda, Hidenori ; Kumada, Takashi ; Osaki, Yukio ; Oka, Hiroko ; Urano, Fumihiro ; Kudo, Masatoshi ; Matsunaga, Takashi</creator><creatorcontrib>Toyoda, Hidenori ; Kumada, Takashi ; Osaki, Yukio ; Oka, Hiroko ; Urano, Fumihiro ; Kudo, Masatoshi ; Matsunaga, Takashi</creatorcontrib><description>Background & Aims:
Previously proposed staging systems for hepatocellular carcinoma (HCC) involve clinical, imaging, or pathologic factors in the evaluation. We established and validated a novel staging system for HCC that is based on simply serum markers.
Methods:
The new scoring system is based on 5 serum markers: bilirubin, albumin,
Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3), α-fetoprotein (AFP), and des-γ-carboxy prothrombin (DCP) and thus is termed the BALAD score. The system was validated in 2600 HCC patients from 5 institutions. The power of our system to predict patient survival and its discriminative ability were compared with those of previously reported staging systems.
Results:
The best tumor marker cutoff values were 400 ng/dL for AFP, 15% for AFP-L3, and 100 milli-arbitrary unit/mL for DCP. The patients were classified into 6 categories on the basis of 5 laboratory values. The categories reflected patient survival well. The discriminative ability was comparable to that of previously reported staging systems.
Conclusions:
The new staging system for HCC combining serum albumin, serum bilirubin, and 3 tumor markers predicts patient outcomes with excellent discriminative ability. The system is easy to use and objective. In addition, stage can be evaluated with the use of only 1 serum sample. It also allows global comparison of patients with HCC or comparison of patients from different time periods with the same standard.</description><identifier>ISSN: 1542-3565</identifier><identifier>EISSN: 1542-7714</identifier><identifier>DOI: 10.1016/j.cgh.2006.09.021</identifier><identifier>PMID: 17162244</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; alpha-Fetoproteins - metabolism ; Bilirubin - blood ; Biomarkers - blood ; Biomarkers, Tumor - blood ; Carcinoma, Hepatocellular - blood ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Humans ; Japan - epidemiology ; Liver Neoplasms - blood ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Male ; Neoplasm Staging - methods ; Plant Lectins - blood ; Protein Precursors - blood ; Prothrombin ; Retrospective Studies ; Serum Albumin - metabolism ; Severity of Illness Index ; Survival Rate</subject><ispartof>Clinical gastroenterology and hepatology, 2006-12, Vol.4 (12), p.1528-1536</ispartof><rights>2006 AGA Institute</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-4a0872e129ecc7982ad7bb0c458149d88dd4a68952a4f3a638924f4397a6f5273</citedby><cites>FETCH-LOGICAL-c417t-4a0872e129ecc7982ad7bb0c458149d88dd4a68952a4f3a638924f4397a6f5273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1542356506009499$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17162244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Kumada, Takashi</creatorcontrib><creatorcontrib>Osaki, Yukio</creatorcontrib><creatorcontrib>Oka, Hiroko</creatorcontrib><creatorcontrib>Urano, Fumihiro</creatorcontrib><creatorcontrib>Kudo, Masatoshi</creatorcontrib><creatorcontrib>Matsunaga, Takashi</creatorcontrib><title>Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers</title><title>Clinical gastroenterology and hepatology</title><addtitle>Clin Gastroenterol Hepatol</addtitle><description>Background & Aims:
Previously proposed staging systems for hepatocellular carcinoma (HCC) involve clinical, imaging, or pathologic factors in the evaluation. We established and validated a novel staging system for HCC that is based on simply serum markers.
Methods:
The new scoring system is based on 5 serum markers: bilirubin, albumin,
Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3), α-fetoprotein (AFP), and des-γ-carboxy prothrombin (DCP) and thus is termed the BALAD score. The system was validated in 2600 HCC patients from 5 institutions. The power of our system to predict patient survival and its discriminative ability were compared with those of previously reported staging systems.
Results:
The best tumor marker cutoff values were 400 ng/dL for AFP, 15% for AFP-L3, and 100 milli-arbitrary unit/mL for DCP. The patients were classified into 6 categories on the basis of 5 laboratory values. The categories reflected patient survival well. The discriminative ability was comparable to that of previously reported staging systems.
Conclusions:
The new staging system for HCC combining serum albumin, serum bilirubin, and 3 tumor markers predicts patient outcomes with excellent discriminative ability. The system is easy to use and objective. In addition, stage can be evaluated with the use of only 1 serum sample. It also allows global comparison of patients with HCC or comparison of patients from different time periods with the same standard.</description><subject>Aged</subject><subject>alpha-Fetoproteins - metabolism</subject><subject>Bilirubin - blood</subject><subject>Biomarkers - blood</subject><subject>Biomarkers, Tumor - blood</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Electrophoresis</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Male</subject><subject>Neoplasm Staging - methods</subject><subject>Plant Lectins - blood</subject><subject>Protein Precursors - blood</subject><subject>Prothrombin</subject><subject>Retrospective Studies</subject><subject>Serum Albumin - metabolism</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><issn>1542-3565</issn><issn>1542-7714</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0E4v0BbJBXCBYNtuPEsVi15SkVWBTW1tSZlJQkLnaC1L8npZXYsZrR6NwrzSHkjLOIM55eLyI7_4gEY2nEdMQE3yGHPJFioBSXu9s9TtLkgByFsGBMaKnVPjngiqdCSHlIzLSFednM6SMuoXUWq6qrwNMxeFs2rgY6W1GgL-4bKzq1zq_Z6Sq0WNPL0XAyvP294hUdQcCcuoZO0Xc1fQb_iT6ckL0CqoCn23lM3u_v3saPg8nrw9N4OBlYyVU7kMAyJZALjdYqnQnI1WzGrEwyLnWeZXkuIc10IkAWMaRxpoUsZKwVpEUiVHxMLja9S---Ogytqcuw_gYadF0waSZiFUvWg3wDWu9C8FiYpS9r8CvDmVlbNQvTWzVrq4Zp01vtM-fb8m5WY_6X2GrsgZsNgP2L3yV6E2yJjcW89Ghbk7vyn_of1VCF0Q</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>Toyoda, Hidenori</creator><creator>Kumada, Takashi</creator><creator>Osaki, Yukio</creator><creator>Oka, Hiroko</creator><creator>Urano, Fumihiro</creator><creator>Kudo, Masatoshi</creator><creator>Matsunaga, Takashi</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20061201</creationdate><title>Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers</title><author>Toyoda, Hidenori ; Kumada, Takashi ; Osaki, Yukio ; Oka, Hiroko ; Urano, Fumihiro ; Kudo, Masatoshi ; Matsunaga, Takashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-4a0872e129ecc7982ad7bb0c458149d88dd4a68952a4f3a638924f4397a6f5273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>alpha-Fetoproteins - metabolism</topic><topic>Bilirubin - blood</topic><topic>Biomarkers - blood</topic><topic>Biomarkers, Tumor - blood</topic><topic>Carcinoma, Hepatocellular - blood</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Electrophoresis</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Liver Neoplasms - blood</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Male</topic><topic>Neoplasm Staging - methods</topic><topic>Plant Lectins - blood</topic><topic>Protein Precursors - blood</topic><topic>Prothrombin</topic><topic>Retrospective Studies</topic><topic>Serum Albumin - metabolism</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Kumada, Takashi</creatorcontrib><creatorcontrib>Osaki, Yukio</creatorcontrib><creatorcontrib>Oka, Hiroko</creatorcontrib><creatorcontrib>Urano, Fumihiro</creatorcontrib><creatorcontrib>Kudo, Masatoshi</creatorcontrib><creatorcontrib>Matsunaga, Takashi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Toyoda, Hidenori</au><au>Kumada, Takashi</au><au>Osaki, Yukio</au><au>Oka, Hiroko</au><au>Urano, Fumihiro</au><au>Kudo, Masatoshi</au><au>Matsunaga, Takashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers</atitle><jtitle>Clinical gastroenterology and hepatology</jtitle><addtitle>Clin Gastroenterol Hepatol</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>4</volume><issue>12</issue><spage>1528</spage><epage>1536</epage><pages>1528-1536</pages><issn>1542-3565</issn><eissn>1542-7714</eissn><abstract>Background & Aims:
Previously proposed staging systems for hepatocellular carcinoma (HCC) involve clinical, imaging, or pathologic factors in the evaluation. We established and validated a novel staging system for HCC that is based on simply serum markers.
Methods:
The new scoring system is based on 5 serum markers: bilirubin, albumin,
Lens culinaris agglutinin-reactive α-fetoprotein (AFP-L3), α-fetoprotein (AFP), and des-γ-carboxy prothrombin (DCP) and thus is termed the BALAD score. The system was validated in 2600 HCC patients from 5 institutions. The power of our system to predict patient survival and its discriminative ability were compared with those of previously reported staging systems.
Results:
The best tumor marker cutoff values were 400 ng/dL for AFP, 15% for AFP-L3, and 100 milli-arbitrary unit/mL for DCP. The patients were classified into 6 categories on the basis of 5 laboratory values. The categories reflected patient survival well. The discriminative ability was comparable to that of previously reported staging systems.
Conclusions:
The new staging system for HCC combining serum albumin, serum bilirubin, and 3 tumor markers predicts patient outcomes with excellent discriminative ability. The system is easy to use and objective. In addition, stage can be evaluated with the use of only 1 serum sample. It also allows global comparison of patients with HCC or comparison of patients from different time periods with the same standard.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>17162244</pmid><doi>10.1016/j.cgh.2006.09.021</doi><tpages>9</tpages></addata></record> |
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| ispartof | Clinical gastroenterology and hepatology, 2006-12, Vol.4 (12), p.1528-1536 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged alpha-Fetoproteins - metabolism Bilirubin - blood Biomarkers - blood Biomarkers, Tumor - blood Carcinoma, Hepatocellular - blood Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Electrophoresis Enzyme-Linked Immunosorbent Assay Female Follow-Up Studies Humans Japan - epidemiology Liver Neoplasms - blood Liver Neoplasms - mortality Liver Neoplasms - pathology Male Neoplasm Staging - methods Plant Lectins - blood Protein Precursors - blood Prothrombin Retrospective Studies Serum Albumin - metabolism Severity of Illness Index Survival Rate |
| title | Staging Hepatocellular Carcinoma by a Novel Scoring System (BALAD Score) Based on Serum Markers |
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