AFP and Cirrhosis: Consequently, curative treatments are no longer feasible because of intra- and extra-hepatic metastases at the time of diagnosis.[2] Currently, the combination of serum alpha-fetoprotein (AFP) and ultrasounds surveillance is the most widely used strategy for screening and detection of HCC in high risk group.[3] However, ultrasound surveillance is limited by sensitivity of the detection and often results in misdiagnosis of small malignant nodules, especially in cirrhosis.