It is suggested that aberrant expression of the PTGS2 gene induced by the genetic variations in its promoter region would result in chronic immune activation and inflammation, uncontrolled cell growth, suppressed apoptosis, precancerous lesions, and subsequent tumor formation.32,33 Therefore, the PTGS2 genetic variants are likely to modulate HCC predisposition through up- or downregulating the expression of the gene they are mapped on. This evidence concerns the gene PTGS2 and neoplasm.