A pilot study with a small sample size found that plasma OPN levels were significantly higher in HCC patients than in cirrhosis patients, chronic hepatitis patients, and healthy controls (118), with a greater AUROC than AFP in discriminating HCC and cirrhosis patients (0.76 vs. 0.71), in discriminating early-stage HCCs and cirrhosis patients (0.73 vs. 0.68), and in discriminating ANHC and cirrhosis patients (0.75 vs. 0.59), and furthermore, in another cohort, an AUROC of 0.87 was observed for distinguishing ANHC from cirrhosis and chronic HBV. This evidence concerns the gene SPP1 and hepatocellular carcinoma.