Abstract: objective To evaluate the value of AFP different isoforms (AFP-L3) for the diagnosis of primary hepatic carcinoma (PHC). Methods Total of 185 patients from January 2013 to July 2013 included 61 patients with primary hepatocellular carcinoma (PHC group), 66 patients with cirrhosis of the liver (liver cirrhosis group) and 58 patients with chronic active hepatitis (chronic hepatitis group) was recruited. Control group has 60 patients of the the corresponding time period healthy physical examination controls. AFP-L3 was detected using affinity adsorption centrifugal tube separation, serum AFP and AFP-L3 levels by was detected using chemiluminescence detection, AFP-L3 10% or more was regarded as positive for diagnostic criteria, the percentage content of AFP-L3 was calculated. Results The serum AFP-L3 positive rate of PHC group, liver cirrhosis group, chronic hepatitis group and control group were 78.02%, 69.8%, 78.26% and 0%, respectively. The difference between AFP-L3 levels of PHC group and that of liver cirrhosis group was not significant (P = 0.062). AFP-L3 level of PHC group was significantly higher than that of control group (P = 0.031). Conclusions AFP-L3 is internationally recognized as useful indicators to differential diagnosis of PHC, but this study shows that in the benign liver diseases, especially in liver cirrhosis with PHC difference is not significant, so the AFP and imaging detection is more advantageous to the diagnosis of PHC.