AFP and hepatocellular carcinoma: When combined with the γ-GT/ALT ratio for the diagnosis of early-stage HCC, the AUROC of PIVKA-II increased (0.858 versus 0.851, respectively), and when combined with the γ-GT/ALT ratio for early-stage HCC diagnosis, the AUROC of AFP increased (0.822 versus 0.617, respectively; P < 0.001).