Abstract： Objective To clarify the expression and clinical significance of metastasis-associated in colon cancer 1 (MACC1) mRNA in hepatocellular carcinoma (HCC).Methods The expression and distribution of MACC1 were assessed by quantitative real-time polymerase chain reaction (RT-PCR) and immunohistochemical staining (IHC) in a cohort of hepatitis B virus-related HCC,including 138 in early (A),96 in intermediate (B) and 120 in advanced stages (C).The association of MACC1 mRNA with disease progression and outcomes was analyzed by univariate and multivariate Cox analysis.Results The intratumoral expressions of MACC1 mRNA in HCC stage Ⅰ (0.001 76,range:0.000 54-0.002 47),stage Ⅱ (0.002 49,range:0.000 55-0.006 78) and stage Ⅲ (0.008 35,range:0.006 86-0.009 88) were about 3-,4-and 14-fold higher than that in the normal liver tissue (0.000 59,range:0.000 57-0.000 60),respectively.Intratumoral expression of MACC1 mRNA increased with disease progression from stage Ⅰ to stage Ⅲ.HCC clinical staging classification,age,portal vein invasion and tumor differentiation were significantly associated with intratumoral high expression of MACC1 mRNA (All P ＜ 0.05).Immunohistochemical staining showed that there was an increased MACC1 expression in cytoplasm of HCC cells and positive nuclear staining in some cases.Increased MACC1 mRNA expression could predict poor outcome and recurrence in stage A and B HCC postoperatively.The median tumor-free survival and total survival of patients with high MACC1 mRNA expression were 34.0 and 40 months,respectively,significantly lower than that in those with low expression (48.0 and 48.0 months) (all P ＜ 0.01).Cox analysis showed that Child-Pugh grading and high expression of MACC1 mRNA were independent predictive factors,and high expression of MACC1 was an independent predictive factor affecting the tumor-free survival.Conclusions MACC1 mRNA up-regulation is a feature of disease progression in HCC.MACC1 mRNA expression in the HCC may become an independent predictive factor for recurrence and survival in postoperative HCC patients.