With the progress of science and technology and the general improvement of health awareness, the role of tumor indicators in physical examination and clinical diagnosis and treatment has become more and more important, and the screening and evaluation of tumor markers has become a hot area of tumor research at present. However, there are some incomplete or even wrong understanding of tumor indicators among clinical patients and their families. 1. Misconception 1: If you have liver cancer, you must have elevated tumor markers. Alpha-fetoprotein AFP is one of the most commonly used clinical tumor indicators. More than 60% of patients with primary hepatocellular carcinoma have different degrees of elevated AFP. However, in China, about 20-30% of patients with hepatocellular carcinoma have negative AFP. In Europe and the United States, the proportion of patients with AFP-negative hepatocellular carcinoma is even higher. Therefore, AFP is not necessarily elevated in liver cancer patients. Another part of the clinical liver cancer classification is intrahepatic cholangiocarcinoma, which often does not have significantly elevated AFP and is not necessarily associated with a hepatitis background. In this part of the population, there is often an elevation of glycoprotein antigen CA19-9. 2. Misconception 2: normal tumor markers will not produce cancer. AFP and CA19-9 can be negative in liver cancer patients, so if AFP and CA19-9 are negative, the possibility of liver cancer cannot be excluded. If you are a high-risk group, you also need to undergo CT or MRI and other impactological examinations. 3. Misconception 3: If the tumor marker is invisible if liver cancer grows, it means the tumor activity is poor. This is also a common perception among clinical patients. Like other tumors, liver cancer has heterogeneity. Some liver cancer cells secrete AFP and some do not, just like all are Chinese, but all are not exactly the same. If AFP is negative, it means that this part of hepatocellular carcinoma cells secrete low AFP, but the growth and invasive activity of these hepatocellular carcinoma cells are non-dependent of AFP concentration, and AFP concentration cannot reflect the activity and malignancy of hepatocellular carcinoma. 4. Misconception 4: If AFP negative liver cancer recurs after resection of liver cancer, AFP is also negative. There are different doctrines of hepatocarcinogenesis in single center and multicenter. AFP of recurrent hepatocellular carcinoma after hepatectomy may be negative or may be elevated. Even if AFP-negative hepatocellular carcinoma after resection patient follow-up needs to be periodically rechecked for AFP.