In HCC, the positive rates of LDHC expression in serum and serum-derived exosomes are 68% and 60%, respectively; the expression of LDHC in serum and serum-derived exosomes in patients receiving treatment was significantly lower than that in the initial diagnosis group; the high expression of LDH-C4 is correlated with the poor prognosis of patients, suggesting an independent risk factor for the prognosis of patients with HCC (13). This evidence concerns the gene C4A and hepatocellular carcinoma.