AFP and hepatocellular carcinoma: Regarding the use of classic biomarkers in the diagnosis of HCC, Zhang et al. conducted a large, prospective cohort study in China involving over 18,000 HBV patients, showing that AFP alone had a sensitivity of only 60% for detecting HCC, particularly lacking in early-stage disease [43] At the same time, Lok et al. evaluated AFP, DCP, and AFP-L3 in a ultrasound-based cohort and found that while DCP improved sensitivity (up to 74%), specificity remained suboptimal, and none of the biomarkers performed reliably across all tumor stages [44].