AFP and hepatocellular carcinoma: Significantly, in the validation cohort, more than 90% LC patients (90.9%, 10/11) who subsequently developed HCC were detected accurately, which was significantly higher than AFP (45.5%, 5/11), PIVKA-II (18.2%, 2/11), AFP + PIVKA-II (81.8%, 9/11), ASAP model (54.4%, 6/11) and aMAP score (72.7%, 8/11), suggesting that the P4 panel could be a good predictor for LC patients at the risk of developing HCC (Fig. 7c, Supplementary Fig. 6b-m).