It was recently identified in the sera of individuals with liver fibrosis related to HCV infection and, based on its proposed role in immune system regulation, was thought most likely associated with viral infection rather than cirrhosis.[25] While this may yet be true, as a mRNA transcript, it has been previously reported upregulated in HCC relative to dysplastic nodules.[26] We have investigated the potential of CD5L as a candidate biomarker for either advanced liver disease, or advanced liver disease and cancer. The gene discussed is CD5L; the disease is hepatocellular carcinoma.