Unlike AIH, MASLD is strongly correlated with HCC development because of metabolic comorbidities that induce dysregulation in molecular pathways, including insulin resistance, oxidative stress, and chronic inflammation, which promote progression to cirrhosis and eventually HCC with MASH playing a critical role in escalating chronic inflammation, hepatic stellate cell activation, and fibrosis (13,37,38). This evidence concerns the gene INS and hepatocellular carcinoma.