Abstract: Objective To investigate the etiology and clinical characteristics in patients with primary liver cancer（PLC）. Methods 573 patients with PLC，diagnosed by serology and hepatic imaging，were enrolled in this study from January 2005 to January 2014 in the Department of Traditional and Western Medical Hepatology，Third Hospital of Hebei Medical University，Shijiazhuang，China. Results The mean age of the patients was（58.7±10.8） years（range 17 to 91 years），of which 79.4% were 40~69 years，with the age of 50 to 69 years as the highest （61.6%）. The ratio of male to female patients was 4.5:1，and the average age in male patients was（57.4±10.3） years，significantly younger than that in female patients [（64.5±11） years，P<0.001]；The prevalence of HBV infection，HBV infection with alcoholic liver disease （ALD），HCV infection and ALD in patients with PLC were 55.3%，26.9%，6.6% and 3.8%，respectively；The average ages of patients with HBV infection and ALD，ALD，HBV infection，and HCV infection were （54.3±8.4） years，（58.4±11.4） years，（58.6±10.6） years and [（67.0±7.8）years，P<0.001]；85.7% of patient with PLC in our series had underlying liver cirrhosis；100（21.2%） and 53 （9.3%） patients had a family history of HBV infection and PLC；In 240 patients with HBV related PLC，serum HBV DNA was detected and the serum HBV DNA levels were observed greater than 1×104 IU/ml in 53.2% of them；The common models of serum HBV markers were HBsAg，anti-HBe，and anti-HBc positive in 57.4%；The serum α-fetoprotein（AFP） level was elevated in 79.1% of patients with PLC，and 39.6% were above 400μg/L，39.4% were 7~400μg/L，and 21.2% were normal. Conclusions HBV infection is the major risk factor for PLC，and alcohol consumption promotes PLC development in individuals with HBV infection. Serum AFP is the marker for PLC，but the diagnostic value needs further assessment.

Key words: Primary liver cancer, Hepatitis B, Hepatitis C, Alcohol, α-fetoprotein