Whatever the underlying mechanisms, the link between the PNPLA3 polymorphism and HCC in alcoholic liver disease appears strong enough to bear practical consequences: the presence of a PNPLA3 148M allele, and especially PNPLA3 148M homozygosity, may provide an easy tool to identify individuals at particular risk for HCC at all stages of alcoholic liver damage. This evidence concerns the gene PNPLA3 and alcoholic liver diseases.