## Alpha-Fetoprotein (AFP) in HCC **Key Point:** AFP is the gold standard tumor marker for hepatocellular carcinoma, produced by malignant hepatocytes and regenerating liver tissue. ### Clinical Utility - **Diagnostic value:** Serum AFP >400 ng/mL in a cirrhotic patient with a nodule >1 cm on imaging is diagnostic of HCC (AASLD criteria) - **Surveillance:** Used in cirrhotic patients to detect HCC early - **Prognostic:** Elevated AFP correlates with tumor burden and poor prognosis ### Sensitivity & Specificity - Sensitivity: 60–70% for HCC - Specificity: High when markedly elevated (>400 ng/mL) - Can be elevated in benign liver disease and germ cell tumors (confounding factor) **High-Yield:** AFP is the most widely used and validated marker for HCC globally; it is part of diagnostic algorithms in AASLD, EASL, and BCLC staging systems.
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