Serum NRCAM (AUC 0.70, 95% CI 0.60–0.80, P < 0.001), akin to AFP (AUC 0.63, 95% CI 0.52–0.74, P = 0.021) and PIVKA-II (AUC 0.71, 95% CI 0.60–0.81, P < 0.001), also displayed moderate predictive accuracy for HCC metastasis. This evidence concerns the gene AFP and hepatocellular carcinoma.