As the diagnostic efficacy of AFP was limited (AUC 0.73, sensitivity 62.12% and specificity 76% at the cut-off value of 7.0 ng/ml) (Figure 4D and Table 2), especially for AFP-negative [AFP(-)] HCC (34), we evaluated the diagnostic potential of L-glu and PA in AFP(-) MetS(+) HCC patients. Here, AFP is linked to hepatocellular carcinoma.