Multivariate Cox regression analysis revealed that old age (1.058, 1.019–1.098, p = 0.003); male gender (2.446, 1.200–4.985, p = 0.014); BMI 25–30 kg/m2 (2.480, 1.203–5.112, p = 0.014); high AST (6.816, 2.945–15.779, p < 0.001), FIB4 score (1.262, 1.154–1.381, p < 0.001), and blood sugar (1.009, 1.002–1.015, p = 0.006); and AFP ≥ 15 ng/mL (143.938, 43.094–480.760, p < 0.001) were independent risk factors for HCC development. This evidence concerns the gene AFP and hepatocellular carcinoma.