EPCAM and hepatocellular carcinoma: This signature effectively stratifies MASLDpatients, discriminating molecular risk groups associated with progression to HCC.<h4>Conclusion</h4>Integrating transcriptomic, clinical and experimental data suggests the role of miR-26a-5p, along with the MASLD-HCC gene signature (EpCAM, DTNA, and KPNA2), may serve as an early molecular indicator and mechanistic modulator of hepatocarcinogenesis, warranting further functional investigation.