AFP and chronic hepatitis: However, the fact that 1) AFP may be elevated in chronic hepatitis without HCC (Force et al., 2022) 2) many small-sized HCCs have normal AFP levels (Carr et al., 2018), 3) 30% of HCC patients have normal AFP levels at diagnosis (Lee et al., 2019) and 4) high AFP levels were found in HCC-free individuals (Kobeisy et al., 2012), highlights the lack of sensitivity and specificity of this marker (Bialecki and di Bisceglie, 2005).