TERT and neoplasm: Since, in our study, advanced-stage HCC harbored fewer TERT mutations compared to early-stage HCC, the higher TERT expression observed in advanced HCC might be a consequence of other telomerase-reactivating mechanisms, including HBV integration into the TERT sequence, TERT gene amplification, or the accumulation of oncogenic pathways with tumor growth, which are distinct from the mechanisms of TERT promoter mutations [6,17].