AFP and cirrhosis of liver: We used ROC curve analysis to assess the clinical utility of ANXA4 and AFP in discriminating patients with HCC from those with liver cirrhosis which revealed that the area under the curve (AUC) for ANXA4 was (0.972), and the best cut off value was115 ng/ml with a sensitivity 95% and a specificity 80%, PPV 93% and NPV 94%, while the AUC for AFP was (0.842) and the best cut off value was 200 ng/ml with a sensitivity 78%, a specificity 90%, PPV 95% and NPV 58%.