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5% showed normal levels in AFP and 68.8% showed normal levels in PIVKA-II. In 36.4% of those patients, both AFP and PIVKA-II showed normal levels. The PIVKA-II-positive ratio was markedly increased with an increase in the tumor size. In contrast, the positivity in AFP was increased gradually and slowly. In the surveillance of very small HCC nodules (≤ 2 cm in diameter, Barcelona clinical stage the tumor markers AFP and PIVKA-II are not so useful. In the surveillance of very small HCC nodules (≤ 2 cm in diameter, Barcelona clinical st