AFP is a glycoprotein that normally comes from embryonic hepatocytes and disappears from the bloodstream about two weeks after birth, so the serum level of AFP is less than 20 micrograms per liter in normal people. However, when hepatocellular carcinoma occurs, the function of producing this protein is restored, and its level in the serum increases dramatically as the disease worsens, making AFP a specific clinical indicator for the diagnosis of primary liver cancer. Alpha-fetoprotein is elevated 8 months before the symptoms of liver cancer appear, when most liver cancer patients still have no obvious symptoms and the tumor is small, and the prognosis of these patients can be significantly improved after treatment. Therefore, liver cirrhosis, chronic hepatitis patients and people with liver cancer in their family should be tested once every six months. AFP will be significantly elevated before the liver mass is detected by ultrasound, CT or MRI, i.e., primary liver cancer can be detected at an ultra early stage, which is the most effective method to detect primary liver cancer recognized by the medical profession and is a mature technology. Qualitative examination can be done in county hospitals, but a positive test does not mean it is liver cancer, it also depends on how high the concentration of AFP is, which requires quantitative AFP examination. Liu Guangwei, Department of Spleen, Gastrointestinal and Hepatobiliary Diseases, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine, normal pregnant women, a few cases of hepatitis and cirrhosis, and malignant tumors of the gonads will also have elevated AFP, but the elevation is not as high as that of liver cancer. In patients with liver cirrhosis, serum fetoprotein concentration is usually between 25 and 200 micrograms/liter, and generally decreases within 2 months as the disease improves, most of which does not exceed 2 months; it is accompanied by elevated transaminases, and when transaminases decrease, fetoprotein also decreases, and serum fetoprotein concentration is often in parallel with transaminases. If the concentration of alpha-fetoprotein is above 500 micrograms/liter, although transaminases are elevated, the possibility of hepatocellular carcinoma is high; if transaminases are decreasing or stable, but alpha-fetoprotein is increasing, hepatocellular carcinoma should also be highly suspected. In more severe chronic hepatitis or cirrhosis, many hepatocytes are destroyed and replaced by extensive fibrous tissue. When there is active inflammatory necrosis, hepatocytes must proliferate rapidly in order to sustain life. A large number of new hepatocytes secrete large amounts of alpha-fetoprotein, so in patients with hepatitis and cirrhosis, a positive alpha-fetoprotein indicates a more severe lesion, but can hepatocytes proliferate to compensate for the destroyed hepatocytes. Therefore, sometimes in patients with liver failure, a mildly elevated AFP is an indication of hepatocyte proliferation and a relatively good prognosis, which is a good sign, while in this case a completely normal AFP indicates no significant hepatocyte proliferation and a poor prognosis. Patients with positive methemoglobin should have ultrasound examination as soon as possible, and if there is an occupying lesion, further MRI or enhanced CT examination should be done to determine the nature of the occupying lesion: whether it is a hemangioma, a sclerotic nodule, or a hepatocellular carcinoma lesion. If no liver cancer lesion is detected by imaging, we still cannot give up our vigilance completely because the best machines and the most experienced doctors can only detect cancerous lesions above 1.0 cm at present, what if the small liver cancer has not grown to 1 cm? That’s why ultrasound and methotrexate test should be done every month. If treated with nucleoside analogs, as serum HBV DNA and transaminase levels decrease, methemoglobin will also decrease significantly. In patients treated with interferon, the inflammation in the liver is slower to dissipate and elevated methemoglobin may fluctuate for several months. If, after antiviral treatment, the viral and inflammatory test data decrease, while the alpha fetoprotein continues to rise, be on high alert for liver cancer! Again: liver cancer is a highly malignant tumor, but small liver cancer within 3 centimeters, where the cancer cells have not metastasized yet, can be best treated by surgery. Never stay alert! Elevated fetoprotein should not be taken lightly. Western medicine has no other treatment for abnormally elevated fetoprotein and highly suspected liver cancer cases that cannot be diagnosed other than antiviral, and there are no drugs that can directly lower fetoprotein. In recent years, I have summarized a set of treatment plan for reducing AFP, which is divided into three types of treatment from the perspective of Chinese medicine, using the method of dredging liver and Qi, clearing heat and detoxification, and activating blood circulation and removing blood stasis, with an effective rate of over 90%. Many of these cases have been cured. Basically, there is no hepatocellular carcinoma within six months after the review of normal alpha fetoprotein, while most of those who have not been treated by TCM are diagnosed with hepatocellular carcinoma within six months. Chinese medicine can play a preventive and curative role in early stage liver cancer, which should be given high priority.