A meta-analysis including 8 studies (N = 1,399) found that serum/plasma OPN had a ability for predicting survival of HCC patients and an accuracy comparable to AFP for HCC diagnosis (the pooled sensitivity and specificity for OPN and AFP were 88 vs. 68% and 87 vs. 97%, respectively) (119); however, there is only one study to evaluate OPN for the diagnosis of early or AFP-negative HCC in this meta-analysis, so further assessment for the diagnostic value of plasma OPN in early and AFP-negative HCC is required. This evidence concerns the gene AFP and hepatocellular carcinoma.