We next examined the relation of HCC45 to other clinical parameters and observed that it remained highly prognostic after adjustment for tumor size, cirrhosis, fibrosis, TNM stages, Barcelona Clinic Liver Cancer stages, vascular invasion, TP53/CTNNB1 mutation status and/or alpha-fetoprotein levels in a multivariate Cox regression analysis: GSE14520 hazard ratio [HR] (HR = 1.89, P = 0.0052), TCGA-LIHC (HR = 1.61, P = 0.033) and LIRI-JP (HR = 2.20, P = 0.024) (Table 1). Here, AFP is linked to fibrosis.