ObjectivesTo systematically review serum a-L Fucose Gan Enzyme (AFU) combined with serum Alpha-Fetoprotein (AFP) in the diagnosis of primary hepatic carcinoma (PHC). MethodsWe comprehensively searched databases including PubMed, The Cochrane Library (Issue 2, 2013), WanFang Data, VIP, CBM, CNKI, EMbase, and Medalink for relevant studies on AFU combined with AFP in the diagnosis of PHC from inception to July 2013; meanwhile, manual search for the relevant Chinese journals were also performed. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using Meta-DiSc 1.4 software. ResultsA total of 20 studies involving 1 350 cases and 2 079 controls were included. The results of meta-analysis showed that, pooled sensitivity, specificity, positive likelihood radio, negative likelihood radio, diagnostic odds ratio, the area under SROC curve and Q index were:a) detection of AFU alone:0.76 (0.74, 0.78), 0.83 (0.82, 0.85), 7.09 (4.34, 11.58), 0.29 (0.23, 0.37), 26.88 (15.04, 48.06), 0.872 6 and 0.803, respectively; b) detection of AFP alone:0.69 (0.67, 0.72), 0.88 (0.86, 0.89), 7.85 (5.35, 11.50), 0.35 (0.30, 0.42), 25.62 (16.35, 40.15), 0.805 4 and 0.740 6, respectively; and c) combined detection of AFU and AFP:0.85 (0.83, 0.87), 0.86 (0.85, 0.88), 7.16 (5.15, 9.96), 0.15 (0.10, 0.23), 54.07 (29.85, 97.95), 0.940 8 and 0.878 5, respectively. ConclusionThe combination detection of AFU and AFP has good efficacy in the diagnosis of PHC.