SPHK1 and hepatocellular carcinoma: Multivariate regression identified peripheral SPHK1, WNT10A, EDN1, and KLF4 as inversely associated with HCC risk, while JUNB showed a positive correlation, independent of confounders like age, gender, and liver function markers.66, 67 These findings highlight the superior discriminatory power of molecular biomarkers compared to AFP, which is elevated in only 60–70 % of HCC cases, and is particularly unreliable in smaller tumors, and DAA-SVR patients who may exhibit normal serum levels despite thrombocytopenia and elevated INR.68, 69, 70