Fox et al modified the BALAD score to evaluate patients with hepatocellular carcinoma. The authors are from the University of Birmingham, University of Liverpool, University of Cambridge, Ogaki Municipal Hospital, Wako Life Sciences Inc and Clatterbridge Cancer Center NHS Foundation Trust.
Patient selection: liver mass, rule out hepatocellular carcinoma
Analytic platform: µTASWako i30 autoanalyzer
Parameters:
(1) serum total bilirubin concentration in µmol/L
(2) serum albumin concentration in g/L
Tumor biomarkers (shared with the BALAD score):
(3) Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3) in percent
(4) alpha-fetoprotein (AFP) in ng/mL
(5) des-gamma-carboxy prothrombin (DCP) in ng/mL
linear predictor =
= (0.02 * ((AFP) -2.57)) + (0.012 ((AFP-L3) - 14.19)) + (0.19 * ((LN(DCP)) - 1.93)) + (0.17 *((SQRT(bilirubin)) - 4.5)) - (0.09 * ((albumin)-35.11))
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Linear Predictor
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Risk Group
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> 0.24
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4 (high)
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-0.90 to 0.24
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3
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-1.73 to -0.91
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2
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<= -1.74
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1 (low)
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where:
• The assignment of risk groups is based on data in Berhane et al. In Fox et al the risk groups are reversed (low if > 0.24 and high if <= -1.74). If you provide data for low or high risk patients the assignment by Berhane makes more sense.
Performance:
• The biomarker assays need to be calibrated.
• The interpretation is affected by racial group.
