Serum-biomarker-based population screening model for hepatocellular carcinoma

This is the authors' abstract. We don't add key points for this paper.

Hepatocellular carcinoma (HCC) early identification is crucial for improving patient outcomes. Current screening methods are often complex and costly. This study developed a simplified, cost-effective HCC screening model using serum marker data. A diverse study population from two Chinese hospitals was recruited, including cancer patients, hospital patients, and healthy individuals. A two-stage screening model was created: LASSO logistic regression for preliminary screening, followed by logistic regression incorporating alpha-fetoprotein (AFP). The model's performance was evaluated in multiple cohorts. Across five populations, the model showed strong performance with AUC-ROC ranging from 0.868 to 0.907, accuracy between 87.43% and 96.96%, and sensitivity over 75% with specificity above 90%. Compared with solely AFP models, the second-stage model improved HCC risk estimates in healthy populations, with significantly higher AUC (0.930 vs. 0.827) and net reclassification improvement (NRI) up to 56.2%. This two-stage model offers a practical, cost-efficient tool for early HCC detection, addressing a significant public health need.