Table 1. Recommendations on the diagnostic role of alpha-fetoprotein as reported in the most recent international guidelines on hepatocellular cancer management.

Group	References	Grade	Year	Ref.
APASL	AFP is not recommended as a confirmatory test in small HCC	1B	2017	(9)
	The cut-off value of AFP should be set at 200 ng/mL for surveillance programs when used in combination with US	2B
	The cut-off value of AFP can be set at lower value in a population with hepatitis virus suppression or eradication	2B
AASLD	Surveillance using US, with or without AFP is suggested every 6 months	2C	2017	(10)
EASL-EORTC	Accurate tumor biomarkers for early detection need to be developed. Data available with tested biomarkers (i.e., AFP, AFP-L3 and DCP) show that these tests are suboptimal for routine clinical practice	2B	2012	(6)
APASL	Surveillance for HCC should be performed by US and AFP every 6 months	2B	2010	(11)
	a-Fetoprotein alone is not recommended for the diagnosis of HCC	1A
	Cutoff value of AFP should be set at 200 ng/mL for diagnosis	1A
	Simultaneous measurement of AFP and DCP provides higher sensitivity without decreasing specificity	1A

APASL, Asian Pacific Association for the Study of the Liver; AFP, alpha-fetoprotein; HCC, hepatocellular cancer; US, ultrasounds; AASLD, American Association For The Study Of Liver Diseases; EASL, European Association for the Study of the Liver; EORTC, European Organization for Research and Treatment of Cancer; DCP, des-gamma carboxy-prothrombin.