CTD-2510F5.4 overexpression promotes HCC proliferation, invasion, and metastasis, correlating with poor prognosis, higher TP53 mutation, increased Treg infiltration, elevated immune checkpoint expression, and impaired immunity. Low CTD-2510F5.4 enhances sensitivity to immunotherapy and anti-angiogenic therapy, while high expression favors chemotherapy response. This evidence concerns the gene TP53 and hepatocellular carcinoma.