AFP and cancer: Our study was also limited by the fact that only a few of the patients with suspected HCC had a confirmatory histopathologic diagnosis and the possibility that other cancers such as cholangio-carcinoma or unspecified types being diagnosed as HCC is plausible, however we limited misclassification of liver metastases as HCC by noting the differing ultrasonographic patterns and use of AFP, generally not elevated with metastases.