Another large multicentric survey showed that AFP-negative (<20 ng/mL) rates were found in 52% (261/502) patients with small HCCs (<3 cm), in 53.5% (51/95) patients at TNM stage I, in 48% (314/656) patients with Okuda stage 1, and in some advanced HCC patients [41.5% (24/58) at TNM stage IV and 28% (17/61) at Okuda stage 3] (6), indicating that nearly a half of HCC patients are AFP-negative, especially early and small HCCs. Here, AFP is linked to hepatocellular carcinoma.