AFP and hepatocellular carcinoma: Furthermore, Yang et al. integrated Liver Imaging and Reporting Data System (LI-RADS) categories with CA 19-9 and AFP to achieve high specificity for differentiating cHCC-CCA from HCC or CCA; however, it was at the cost of poor sensitivity, since only 3 out of 35 patients (8.6%) had simultaneously elevated CA 19-9 and AFP [36].