Controversies regarding and perspectives on clinical utility of biomarkers in hepatocellular carcinoma

Figure 1 The clinical utility of biomarkers according to typical hepatocellular carcinoma guidelines worldwide. A: Typical hepatocellular carcinoma (HCC) guidelines in Western countries; B: Typical HCC guidelines in Asian countries. ¹Alpha-fetoprotein (AFP) alone is not recommended for diagnosis of HCC; the measurement of both AFP and des-γ-carboxyprothrombin (DCP) provides a higher level of sensitivity without decreasing specificity; ²AFP ≥ 400 ng/mL over 1 mo or AFP ≥ 200 ng/mL over 2 mo; ³Optional examinations include computed tomography (CT)-angiography, liver-specific contrast-enhanced magnetic resonance imaging (MRI), contrast ultrasound (US), or liver tumor biopsy.