Alpha-fetoprotein (AFP) is a specific clinical indicator for the diagnosis of primary hepatocellular carcinoma. The level of AFP in normal human serum is still less than 20 μg/L. In about 80% of patients with primary liver cancer, AFP is elevated, and the elevation occurs 6-12 months before the onset of symptoms. Three items are checked in the blood draw: alpha-fetoprotein (AFP), carcinoembryonic antigen, and serum CA19-9 to. Some patients only have the AFP test done for various reasons, but what I would like to say today is that based on the AFP test result alone, does a normal value of it necessarily mean that there is no liver cancer? A large number of clinical findings show that about 20% of liver cancer patients have normal AFP until the discovery of liver cancer, while carcinoembryonic antigen CEA and serum CA19-9 are high. I have a patient’s case here: General information: Xu, male, 79 years old. Complaint: HBsAg(+) was found for 40 years, and intermittent vague pain in the liver area for more than 1 year. History: HBsAg(+) was found 40 years ago during physical examination and was treated with hepatoprotective drugs, the details of which are not known, and was not followed up for review. 1 year ago, he developed vague pain in the liver area, accompanied by loss of appetite, and was found to have intrahepatic occupancy on external examination. He was diagnosed as “primary hepatocellular carcinoma and viral chronic hepatitis B”, given hepatoprotective and antitumor drugs, and hepatic artery chemoembolization, and then he underwent hepatic artery chemoembolization several times in September, November 2014, February, April, June and August 2015 due to the residual tumor tissue. He was discharged from the hospital and continued with hepatoprotective and antitumor therapy. Recently, the patient had a fair appetite, occasional pain and discomfort in the liver area, no fever, no nausea, vomiting, abdominal pain and abdominal distension, and was readmitted to the hospital for further treatment. Diagnosis: “1. Recurrence of primary hepatocellular carcinoma 2. Viral hepatitis chronic active type B”. Treatment record: Hepatic artery chemoembolization was performed, and liver preservation and anti-tumor treatment continued after discharge. With examination pictures: report card. Discussion: This patient was found to be surface antigen positive for 40 years and had vague pain in the liver area 1 year ago. The patient’s methemoglobin was always normal in the review, and the carcinoembryonic antigen and serum CA19-9 were high. Therefore, we would like to remind the patients that they should not only check the fetoprotein during the review, because normal fetoprotein does not mean that there is no problem, and they should not delay the treatment of the disease.