Abstract: Objective : To evaluate the clinical significance of telomerase activity detection in biopsied tissues for evaluating the therapeutic efficacy of laparoscopic radiofrequency ablation (LRFA) for patients with hepatocellular carcinoma (HCC) and liver cirrhosis. Methods : From August 2001 to October 2004, 34 patients with HCC and liver cirrhosis were treated by LRFA under general anesthesia, among which 27 were male and 7 female, with a mean age of 49.9±11.7 years. The mean maximum diameter of the tumors was 4.0±1.0cm (median, 4.1cm). All of the tumors were located on the liver surface, in the lateral segment of the left lobe, or were adjacent to the gallbladder. Laparoscopic ultrasound examination and biopsy of liver nodules were performed before LRFA and immediately after LRFA for telomerase activity detection by ELISA-telomeric repeat amplification protocol (ELIS-TRAP) assay and pathological examination. Results : All patients were treated with LRFA successfully. The positive rates of histopathologic diagnosis and telomerase activity detection in biopsied tissues were 100% (34/34) and 91.2% (31/34) respectively before LRFA, and 0% and 26.5% respectively after LRFA. The contrast-enhanced helical CT scans showed that a complete lesion necrosis was achieved in all patients one month later. During a median follow-up period of 21 months (range, 7-40 months), 88.9% (8/9) patients with positive telomerase activity after LRFA recurred locally at the ablation sites, and 8% (2/25) patients with negative telomerase activity after LRFA had new malignant nodules within the livers. Conclusion : After LRFA therapy for patients with HCC and liver cirrhosis, detection of telomerase activity in biopsied tissues may be useful for evaluating the therapeutic efficacy of LRFA therapy and predicting postoperative recurrence.