AFP and hepatocellular carcinoma: Most recently, Li et al. reported that the GGT/ALP ratio combined with GGT/ aspartate aminotransferase (AST) ratio and alanine aminotransferase (ALT)/AST ratio can be used for accurate screening alpha fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) [34], confirming the important role of GGT and ALP in liver tumor evolution.