Abstract: Objective The aim of this study was to investigate the clinical characteristics and prognostic factors of primary liver cancer (PLC) patients with serum AFP negative (＜20 ng/ml) . Methods The clinical data of 34 patients with AFP-negative PLC were retrospectively analyzed in our hospital from March, 2013 to March, 2017. The relevant data were processed by SPSS17.0 statistical software, and the overall survival rate was estimated by Kaplan-Meier method. COX regression model was applied to analyze the prognostic factors of patients with AFP-negative PLC. Results During the 3-year follow-up, the 1-year, 2-year and 3-year survival rates of our 34 patients were 91.2%, 85.3% and 73.5%, respectively; univariate analysis showed that there was significant differences in survival period between patients with different tumor size (maximum diameter ≤ 5cm and ＞ 5cm, between patients with and without distant metastasis, between patients with and without portal vein tumor thrombus, between patients with Child-Pugh class C and those with Child-Pugh class B, between patients with high histological differentiation and low histological differentiation , between patients with distant metastasis and without metastasis, between patients with high serum CEA level and normal CEA level, between patients with CR and PD after treated with TACE, and between patients having radiotherapy and those without receivingradiotherapy(P＜0.05); COX analysis showed that portal thrombus formation, poor Child-Pugh class, low histological differentiation, distant metastasis, high serum CEA level, poor response to TACE and no radiotherapy were all the independent prognostic factors of patients with AFP negative PLC (all P＜0.05). Conclusion The prognosis of patients with serum AFP negative PLC is related to many factors, and the patients with complete remission of tumor after TACE and having radiotherapy might even have a better prognosis.

Key words: Hepatoma, AFP negative, Prognosis, Survival rate