Objective  To determine a reliable prognostic marker for hepatocellular carcinoma(HCC), we investigated the prognostic significance of the relationship between the number of CD68⁺ tumor-associated macrophages(TAM) and Ki-67.

Methods  SABC immunohistochemistry was used to observe the distribution of TAM marker CD68⁺ and the protein expression of proliferation index Ki-67 in HCC tissues from 73 patients who had complete histories and were followed up for more than five years. AFP in those patients’ serums was detected by chemiluminescent immunoassay(CLIA).

Results  The positive rate of Ki-67 was significantly higher in CD68⁺ high-density group, compared with CD68⁺ low-density group (P=0.0191). There was no correlation between the number of CD68⁺ TAM and age, gender(P>0.05). The number of CD68⁺ TAM was correlated positively with histological grade(P=2.83E-04). However, no correlation between the serum AFP level and age, gender or histological grade was observed(P>0.05). The overall survival (OS) in high CD68⁺ TAM group was significantly shorter than that in low CD68⁺ TAM group (P=0.0004). Nevertheless, no statistical significance was found in OS or Ki-67 positive rate between high AFP and low AFP group (P>0.05).

Conclusion  CD68⁺ TAM number is closely correlated with HCC proliferation activity and is an independent risk factor for HCC prognosis. Compared with AFP, CD68⁺ TAM might serve as a prognostic marker for HCC.