Ferritin is a soluble tissue protein that stores iron in the body. Normal human serum contains a small amount of ferritin, but different assays have different normal values, generally the normal average value is about 80-130ug/L (80-130ng/ml) for men and 35-55ug/L (35-55ng/ml) for women. The serum iron level decreases in pregnancy and acute anemia, and increases in acute and chronic liver damage and liver cancer, and the positive rate is reported to be as high as 90% in liver cancer patients in China. Ferritin is a protein with a large molecular weight and is the main form of iron storage in the body. Ferritin is measured at 400ng/ml as the upper limit of normal, and is often elevated and greater than this value in certain tumors, commonly in: acute leukemia, Hodgkin’s disease, lung cancer, colon cancer, liver cancer and prostate cancer. Detection of ferritin has diagnostic value for metastatic tumors in the liver. 76% of patients with liver metastases have ferritin levels higher than 400ng/ml. Combined testing with AFP, especially in patients with liver cancer with normal AFP, can improve the diagnostic rate. The elevated ferritin may be due to cell necrosis, blocked erythropoiesis or increased synthesis in tumor tissue. Ferritin measurement is suitable for understanding iron metabolism in the body and is currently detected by radioimmunoassay and enzyme-linked immunosorbent assay. This test is an important indicator for the diagnosis of iron deficiency anemia and is one of the markers of malignancy. The detection of ferritin at the beginning of treatment can reflect the iron stores in the body at that time, and can detect the deficiency of iron stores in the reticuloendothelial system at an early stage. In clinical practice, a threshold of 20ng/ml can effectively determine latent iron deficiency and indicate depletion of iron stores. Under normal conditions stored iron can be used for hemoglobin synthesis and below 12ng/ml, latent iron deficiency is judged. Both of these measurements, without further laboratory references, remain true even in the presence of normal blood cell morphology. The presence of iron deficiency is indicated if there is also microcytic hypochromic anemia. If the ferritin level is high and the possibility of an abnormal iron supply is excluded, this reflects a condition of excess iron in the body. The concentration of plasma ferritin is proportional to the amount of iron stored in the body. For several years, it has been found that hepatocellular carcinoma also contains an acidic isoferritin called carcinoembryonic isoferritin, which may help in early diagnosis. Therefore, serum ferritin measurement can be used as a means of monitoring the efficacy of hepatocellular carcinoma, especially for patients with negative AFP. Elevated serum ferritin is due to an increased source of ferritin or impaired clearance. For example, in liver cancer, lung cancer, pancreatic cancer, leukemia, etc., the synthesis of ferritin by cancer cells increases, resulting in increased serum ferritin. Decreased function of damaged liver cells when suffering from liver disease, which raises serum ferritin. Increased serum ferritin, aplastic anemia (decreased iron utilization), hemolytic anemia (excessive iron release); hemochromatosis and repeated blood transfusions (increased iron absorption or storage), anemia due to lead poisoning and vitamin B6 deficiency (decreased iron utilization), malignant tumors, liver lesions, acute infections. The reasons for increased ferritin in hepatocellular carcinoma patients may be: ① hepatocellular carcinoma cells can synthesize and secrete ferritin or isoferritin. ② The uptake and clearance of ferritin by liver cancer tissues are affected. (3) Hepatocyte damage and necrosis, and the ferritin stored in hepatocyte plasma spills into the blood. Although serum ferritin is non-specific, it is not elevated in other GI tumors such as esophageal cancer, gastric cancer and rectal cancer, except for liver cancer and pancreatic cancer which are moderately elevated. The symptoms of high ferritin are as follows: 1. Since liver cancer is a cancerous transformation of liver cells, there will be hidden pain or intermittent dull pain or distension in the liver area and epigastric distension. 2.In the early stage, the symptoms of liver cancer are extremely insidious, often only loss of appetite, epigastric stuffiness and weakness, and mild hepatomegaly will appear in ultrasound examination. 3.Symptoms such as weakness of limbs, emaciation, general weakness and easy fatigue, etc. are usually bedridden in the middle and late stages.