Abstract: Objective:To investigate the expression of soluble endoglin in patients with liver cirrhosis and hepatocellu -lar carcinoma (HCC) and to determine its clinical significance. Methods:We used Enzyme-Linked Immunosorbent Assay (ELISA) to measure the serum concentration of soluble endoglin in 87HCC patients,30hepatic cirrhosis patients and28 healthy controls. We also collected the clinical data of all of these patients and analyzed the relationship between soluble endoglin serum level and tumor stage, portal vein thrombus, and distant metastasis. Results: The serum concentration of soluble endoglin in patients with HCC and hepatic cirrhosis was significantly higher than that in patients with hepatic cirrho-sis ( P<0.001 ) and the control group (P<0.001 ). The serum concentration of soluble endoglin in the hepatic cirrhosis group was significantly higher than that in the control group (P=0.016 ). The serum concentration of soluble endoglin was highest in HCC patients with a tumor mass larger than 5 cm, distant metastasis, portal vein thrombus, an AFP level higher than400 ng/mL and at a later clinical stage. ROC analysis showed that combined tes for endoglin and AFP levels has higher sensitiv-ity than assessing either alone, and the AUC was increased. Conclusion:Soluble endoglin has the potential to be a novel complementary biomarker in the risk assessment for development of HCC in cirrhotic patients and can be used as an early diagnostic index. Soluble endoglin can be used as a marker for the recurrence, metastasis and prognosis of HCC.