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Studies have shown that in contrast to a normal liver, there is an upregulation of FZD3/6/7 and Wnt3/4/5a expression in 95% of HCC and 68% of the surrounding tumor tissues, along with downregulation of sFRP1/5, which accumulates progressively with tumor advancement and the severity of fibrosis in surrounding tissues (72)

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These risks highlight the need for individualized assessments before intervention, standardized dosing and duration, and long-term safety monitoring to ensure clinical applicability and minimize potential harms

Elevated B12 levels likely enhanced oocyte maturation and embryo viability through improved methylation capacity [7], as evidenced by the positive correlation between B12 levels and embryo morphology in our cohort (Table 2)