AFP and hepatocellular carcinoma: Although AFP combined with CA19-9 and CEA, has a specificity of 100% and a positive predictive value of 100% its low sensitivity of 2.5 % makes it use as a screening tool inferior to AFP alone in HCC and differentiating HCC from non-HCC patients, and therefore not a suitable substitute in screening of potential HCC patients, however it can aid in the definitive diagnosis of HCC and exclude HCC as the primary.