In the other hand, certain missense mutations in the SERPINA1 gene, as the PI*Z allele, cause the accumulation of toxic aggregates of misfolded AAT in the endoplasmic reticulum of hepatocytes, switching on a cellular stress response that may result in diverse clinical presentations as neonatal cholestasis or late-onset cirrhosis and hepatocellular carcinoma in adults (1, 2). Here, SERPINA1 is linked to hepatocellular carcinoma.