GALAD is a combination of 3 different biomarkers, AFP, AFP-L3, and DCP, as well as age and gender, which has previously been shown to have high sensitivity for early HCC detection in patients with cirrhosis.13 Only 1 Italian study previously measured AFP, AFP-L3, and DCP levels in a small cohort of patients (44 CLD with no HCC and 54 HCC patients with HCV or HBV etiology). The gene discussed is AFP; the disease is congenital secretory chloride diarrhea 1.