Protein Biomarkers in the Management of Hepatocellular Carcinoma: Novel Combinatory Approaches

  • Philip JohnsonEmail author
  • Sarah Berhane
Part of the Current Clinical Oncology book series (CCO)


Several serum biomarkers have been proposed for diagnosis and assessment of prognosis in hepatocellular carcinoma (HCC) but none has entered routine clinical practice despite achieving reasonably high values for sensitivity, specificity and area under the ROC curve. After reviewing some of these we show how the performance of individual biomarkers may be enhanced by combining several different biomarkers in rigorously developed and validated statistical models. In such models the constituent biomarkers are considered as continuous variables rather than, as in conventional clinical practice, dichotomised with the application of cut-off points. This approach maximises the information extracted from the available data. We illustrate this concept with reference to the ‘GALAD’ model for diagnosis and the ‘BALAD’ model for prognosis both of which improve the utility of the individual constituent biomarkers.


Chronic Liver Disease Sustained Virological Response Lens Culinaris Agglutinin Indocyanine Green Clearance Assess Liver Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Molecular and Clinical Cancer MedicineUniversity of LiverpoolLiverpoolUK
  2. 2.The Clatterbridge Cancer Centre NHS Foundation TrustBebingtonUK

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