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would reduce the number of patients requiring screening by imaging to one-fourth the original number.
Further analysis in a large cohort is required to validate this screening method.

DECLARATIONS
Acknowledgements
We thank Wako Pure Chemical Industries for measuring tumor markers in patients with diabetes mellitus.

Authors’ contributions
Design of the work, data analysis, interpretation and preparation of this manuscript: Nouso K
Data collection, data update and acquisition of serum samples: Furubayashi Y
Data collection, database construction: Shiota S, Wakuta A, Oonishi A, Kariyama K, Takeuchi Y, Wada N,
Onishi H, Adachi T, Oyama A, Dohi C, Yasunaka T, Yasunaka Y, Ikeda F, Shiraha H, Takaki A
Gave advise for conducting the whole work: Okada H

Availability of data and materials
The data will not be shared because the patients did not give their consents for the data to be analyzed by the
third party.

Financial support and sponsorship
Wako Pure Chemical Industries measured tumor markers in patients with diabetes mellitus.

Conflict of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
All HCC patients provided written informed consent to use their clinical records for this study. In addition,
written informed consent was obtained from the control group patients for tumor marker (AFP and DCP)
measurement and use of clinical data. The study protocol conformed to the tenets of the Declaration of Hel-
sinki and was approved by the institute ethics committees.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.

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