Abstract: Objective : To evaluate the clinical significance of telomerase activity in percutaneous fine-need biopsied tissues of hepatocellular carcinoma (HCC). Methods ： 25 patimts with small HCC (1.2-3cm in diameter) were treated with percutaneous ethanol injection therapy (PEIT).Fine-needle biopsies by ultrasound guidance were performed in all HCC nodules before PEIT and one week after PEIT for detection of telomerase activity by non-radioisotopic silver staining telomeric repeat amplification protocol (TRAP) and histopathological diagnosis. Liver-biopsied samples from 3 normal liver tissues and 5 cirrhotic liver tissues were used as control groups. Results ： The positive rates of histopathological diagnosis and telomerase activity detection in biopsied tissues before PEIT were 80T (20/25) and 84%(21/25), respectively. In re-biopsied tissues after PEIT, residual neoplastic cells were not demonstrated by histopathological examination in all cases, and telomerase activity were detected in 3 cases (12T). Among the 3 cases with persistent telomerase activity, one case had no recurrence after hepatectomy and the remaining 2 cases showed local recurrence within one year. 22 cases with negative telomerase activity after PEIT were not recurred during follow-up within one year. There was no telomerase activity in 3 normal liver tissues and 5 cirrhotic liver tissues. Conclusions ： Detection of telomerase activity in percutaneous fine-needle biopsied tissues can be used as an alternative adjuvant diagnostic method for small HCC, and might be applied in evaluating the therapeutic efficacy of PEIT and judging the prognosis for HCC.