Abstract: Objective : To determine the absolute and relative value of microvessel density (MVD),vascular endothelium growth factor (VEGF) protein and its reptors (VEGFR: Flt-1、Flk-1) proteinexpression in primary tumor and preoperative serum VEGF in predicting recurrence of primary hepato-cellular carcinoma (PHCC). Methods : using immunohistochemistry to detect the expression of MVD,VEGF, Flt-1 and Flk-1; using ELISA to detect preoperative serum VEGF of PHCC patients; and evalu-ated their correlation with the prognosis. Results : MVD, VEGF, Flt-1, Flk-1 and serum VEGF werepositively correlated with tumor diameter, staging, differentiation and cancer embolus (P<0.05). MVD,VEGF, Flt-1, Flk-1 and serum VEGF were positively correlated with recurrence (P<0.05;0.003,0.013,0.031,0.026, respectively); Univariate analysis by Kaplan-Mierer survival analysis showed thatMVD, VEGF, Flt-1 and Flk-1 expression and serum VEGF were all significantly predictive of DFS(disease-free survival) (P<0.05;0.0045, 0.0287, 0.0021, 0093, 0.0472, 0.0201,respectively). Conclusions : MVD, VEGF, Flt-1 and Flk-1 expression and serum VEGF are all independent prognostic in-dicators for recurrence; and combination of them would be more useful in predicting prognosis. Owing to its convenience,serum VEGF may be the most prospective predictor for high-risk recurrence.