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All 134 participants achieved sustained virological response at 12\u2009weeks (SVR12) with DAA therapy, and serum TSP2 levels significantly decreased from before and after treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). During the median follow\u2010up period of 6.0\u2009years, HCC after DAA therapy was observed in 16 patients (11.9%). Patients with serum TSP2 High (\u2265\u200932\u2009ng\/mL) at SVR12 had a significantly higher cumulative occurrence of HCC than did those without (26.5% vs. 7.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0033). A multivariate Cox proportional hazards model identified male gender (HR 4.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), HCC history (HR 4.61, <jats:italic>p<\/jats:italic>\u2009=\u20090.017) and TSP2 High (HR 3.93, <jats:italic>p<\/jats:italic>\u2009=\u20090.009) as significant independent predictors of HCC occurrence after DAA therapy. The model had a high concordance index of 0.878. Additionally, combining TSP2 High and FIB\u20104 High (\u2265\u20093.538) at SVR12 yielded high specificity and negative predictive value (0.941 and 0.917, respectively) for predicting HCC. Kaplan\u2013Meier analysis showed a higher HCC incidence in the TSP2 High + FIB\u20104 High group (log\u2010rank <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). In conclusion, TSP2 may be a promising biomarker for personalised HCC surveillance in DAA\u2010treated hepatitis C patients.<\/jats:p>","DOI":"10.1111\/jvh.14025","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T08:48:24Z","timestamp":1728982104000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Thrombospondin 2 as a Predictive Biomarker for <scp>HCC<\/scp> in\u00a0Hepatitis C Patients: A Longitudinal Study Following <scp>DAA<\/scp> Therapy"],"prefix":"10.1111","volume":"32","author":[{"given":"Takanobu","family":"Iwadare","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Shinshu University School of Medicine  Matsumoto Nagano 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