AFP and hepatocellular carcinoma: In clinical practice, serum a-fetoprotein (AFP) and ultrasonography are widely utilized for early detection of HCC.[5] However, with a sensitivity (SN) of 53% and specificity (SP) of 90% at a cut-off value of 20 ng/ml, western countries have excluded AFP for HCC diagnosis due to its lack of accuracy.[6–8] Furthermore, AFP-negative HCC could be missed if it is used as a marker for diagnosis of HCC.