AFP and neoplasm: Due to technical limitations, ultrasound images are often unrecognizable for HCC nodules, especially less than 1 cm.1, 2 Unexpectedly, AFP is measured separately in early HCC with a missed diagnosis rate of 40%.3 AFP‐negative hepatocellular carcinoma (AFP‐NHCC) is an important type of HCC that currently causes many patients to lose early diagnosis and treatment, especially in patients with tumors less than 3 cm.4 The clinical symptoms of AFP‐NHCC patients are usually mild and lack specificity, and their clinical diagnosis relies mainly on other tumor markers or imaging.