The fifth leading cause of cancer death in our country. Most originate from viral liver diseases. With changes in lifestyle, the number of patients with metabolic dysfunction-associated steatohepatitis (MASH), which progresses from metabolic dysfunction-associated steatotic liver disease (MASLD) to cirrhosis and liver cancer, is increasing. Many serum proteins are produced in the liver, so differences in their glycoprotein glycans are likely to be biomarkers for inflammation and cancer. Known tumor markers for liver cancer include AFP (alpha-fetoprotein) and PIVKA-II, but neither tumor marker is present in 20–30% of cases. AFP-L3 (fucosylated AFP), a glycan biomarker with high specificity for liver cancer, is also clinically applied [1]. A paper has been reported that examined the gene expression of Fut8, which is involved in the biosynthesis of AFP-L3, in liver cancer tissue [2]. M2BPGi, a new glycan biomarker that indicates liver fibrosis (especially in chronic hepatitis C), is also attracting attention [3]. The fucosylated haptoglobin we developed is expected to be a glycan biomarker that can predict the onset of liver cancer by reflecting liver inflammation and hepatocyte deformation [4]. The concept is shown in Fig. 94.1.