Jerry Adesola Adeyemo1✉, Micheal Abimbola Oladosu2✉, Moses Adondua Abah3
1Department of Internal Medicine, Rems Muhr Krankenhaus, Winnenden, Germany
2Department of Chemical Sciences, Faculty of Science, Anchor University Lagos, Ayobo-Ipaja, Lagos, Nigeria
3Department of Biochemistry, Faculty of Pure and Applied Sciences, Federal University of Wukari, Wukari, Taraba State, Nigeria.
(✉) Corresponding Author
Received: April 24, 2026/ Revised: May 27, 2026/Accepted: June 2, 2026
Highlights
- Reviews the diagnostic and prognostic roles of alpha-fetoprotein in hepatocellular carcinoma.
- Evaluates AFP sensitivity, specificity, and clinical performance across disease stages.
- Examines the interpretation and limitations of different AFP cut-off values.
- Highlights challenges associated with false-positive and false-negative AFP results.
- Emphasizes the need for complementary biomarkers and imaging-based HCC diagnosis.
Abstract
Alpha-fetoprotein (AFP) has been extensively utilised as a serum biomarker for hepatocellular carcinoma (HCC) diagnosis and surveillance for over five decades. Despite its widespread clinical application, AFP presents significant limitations in diagnostic accuracy due to variable sensitivity and specificity across different populations and disease stages. This review comprehensively examines the biological origin of AFP, its diagnostic performance in HCC detection, the clinical interpretation of various AFP cut-off values, and the challenges posed by false-positive and false-negative results. We analyse current evidence from 2020-2025 regarding AFP’s diagnostic value, prognostic significance, and clinical limitations. Understanding these aspects is crucial for optimal utilisation of AFP in clinical practice and the development of more effective diagnostic strategies for HCC. This review provides clinicians and researchers with updated insights into AFP’s role in HCC management and highlights the need for complementary biomarkers and imaging modalities to enhance diagnostic accuracy.
Keywords: Alpha-fetoprotein, Hepatocellular carcinoma, Biomarker, Diagnostic accuracy, Sensitivity, Specificity, Cut-off values engineering futur
How to cite this article
Adeyemo, J. A., Oladosu, M. A., & Abah, M. A. (2026). Alpha-fetoprotein in hepatocellular carcinoma: Diagnostic value, prognostic significance and clinical limitations. Science Archives, 7(2), 61–73. https://doi.org/10.47587/SA.2026.7205
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