Published online Sep 27, 2020. doi: 10.4254/wjh.v12.i9.558
Peer-review started: May 27, 2020
First decision: June 15, 2020
Revised: July 6, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: September 27, 2020
Core Tip: The use of ultrasound with/without alpha-fetoprotein in the context of screening patients with chronic liver disease for the development of early stage hepatocellular carcinoma that is treatable, remains problematic. Consequently there has been considerable work done to examine biomarkers either individually, or in combination to address this deficiency. Whilst there are several promising targets (discussed in this manuscript) for this indication it appears that Gender, Age: Lens culinaris agglutinin-reactive of alpha-fetoprotein, Alpha-fetoprotein, and Des-γ-carboxy prothrombin, which has been established in Europe and Japan, and remains to be so in North America, may be clinically the best performer available.