Increased serum ACE2 was significant in HCC compared with controls (p value <0.0001), and ACE2 sera expression was significantly upregulated between fibrosis or cirrhosis versus HCC (p values of <0.005 and <0.04, respectively), suggesting that elevated serum ACE2 expression can distinguish between patients with fibrosis/cirrhosis versus HCC. The gene discussed is ACE2; the disease is fibrosis.