Abstract: Hepatocellular carcinoma (HCC) is the second common cause of cancer incidence and death amongEgyptian men. á-fetoprotein (AFP) may be elevated in many liver diseases and is not elevated in all patientswith HCC, So more sensitive serum markers are needed for HCC diagnosis. AFP glycoform measuring is moreimportant than measuring of AFP. There are three types of glycoforms, the most important one in diagnosis ofHCC is lens Culinaris agglutinin reactive 3 alpha fetoprotein (AFPL3), as it is generated from malignant livercells, its measurement helps to differentiate HCC from benign hepatic diseases. The aim of the present studywas to improve outcome of patients with HCC by early diagnosis, through detection of AFP L3 in patients withnormal level of AFP. This study included 82 patients divided into two groups: Group (A): 41 HCC patients withnormal Alpha fetoprotein level, Group (B): 41 HCC patients with high level of Alpha fetoprotein. Tri-phasic liverComputed  Tomography  (CT)  is  a  standardized  procedure  for  the  detection  and  characterization  of  HCC.Measurement of Human AFP-L3 by ELISA in serum by the kit (AFPL3 EIAab®, Catalog No: E1117h). Resultsshowed that out of 82 patients 18 patients were females and 64 were males with mean age 63.5years old. AFPL3 at cutoff 2.89 had sensitivity of 100% and specificity of 87.8%, AUC=0.515 and accuracy of 93.2% accordingto this cutoff 95% of patients with AFP <30 ng/mL had AFP L3 =2.89 versus 5% of patients with AFP <30 ng/mLhad AFP L3 >2.89, while 100% of patients with AFP >30 ng/mL had AFP L3 >2.89 versus 0% of patients withAFP >30 ng/mL had AFP L3 =2.89, this indicates that AFP L3 is a good diagnostic marker for HCC when AFPlevel is more than 30 ng/ml. Conclusion: There is a significant direct correlation between AFP level and AFPL3level in patients with HCC. AFP L3 is a good diagnostic marker for HCC only when AFP level is more than 30ng/ml.

Key words: HCC · Alpha fetoprotein · Alpha fetoprotein L3