Similarly, no significant differences in serum concentration between (primary and secondary) patients with liver cancer and healthy controls were observed in a recent study by Wirtz et al.27 They noted, however, that a lower level of MIF is associated with longer overall survival after transarterial chemoembolization treatment.27 In contrast, other studies reported higher circulating MIF levels in samples from patients with HCC compared to healthy control subjects or patients with other liver diseases, correlating with a worse prognosis (eg,28,29). This evidence concerns the gene MIF and liver disorder.