In this connection, Lu et al. previously found inflammatory SPINK1 to prevent cytolytic granule granzyme A-mediated apoptosis/immune-killing47; and that SPINK1 secreted by stromal cells in a damaged tumor microenvironment following chemotherapy, can promote more aggressive cancer phenotypes32; additionally, Jia et al. demonstrated SPINK1 as a potential biomarker for the early detection, targeted therapy, and prediction of immune checkpoint blockade (ICB) treatment response in HCC patients48. This evidence concerns the gene SPINK1 and hepatocellular carcinoma.