Revolutionizing early HCC detection: groundbreaking validation of the HCC-check index for small tumors in Egyptian patients using CLIP and BCLC staging systems

Hepatocellular carcinoma (HCC) is often associated with better treatment options for small asymptomatic tumors if HCC is caught early. A year ago, the "Technology in Cancer Research and Treatment" Journal published a report on the highly sensitive HCC-Check for the early diagnosis of HCC. Here, we examine and confirm the applicability of HCC-Check in 486 liver-diseased patients with earlier stages of HCC based on two widely used Cancer of the Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems for the identification of small tumors. Our results showed that HCC-Check produced 0.90 AUC with 78.26% sensitivity and 83.89% specificity, when used to distinguish small HCCs from cirrhotic patients. Our findings showed that HCC-Check increased with disease progression according to the CLIP and BCLC systems, producing significant (p < 0.0001) Spearman correlation coefficients of 0.633 and 0.458, respectively. HCC-Check yielded 0.85 (0.78-0.92) AUC, 66.67% (47.19-82.71) sensitivity, and 83.89% (77.69-88.94) specificity for identifying CLIP (0-1) while producing 0.87 (0.79-0.94) AUC, 65% (40.78-84.61) sensitivity, and 83.89% (77.69-88.94) specificity for identifying BCLC A. Additionally, HCC-Check yielded 0.90 (0.83-0.97) AUC, 78.26% (56.30-92.54) sensitivity, and 83.89% (77.69-88.94) specificity for discriminating small tumors < 3 cm. Simplified HCC-Check still competes with HCC-Check, providing 0.89 (0.83-0.95) AUC with 73.91% (51.60-89.77) sensitivity and 82.51% (76.22-87.72) specificity for identifying small-sized HCC. All these results were superior to those obtained by AFP. In conclusion, the study findings support that HCC-Check and its simplified version could be a useful tool for early detection of HCC, aiding definitive treatment.