AIM:To elucidate the relationship between the microvessel count(MVC)by CD34 analyzed by immunohistochemical method and prognosis in hepatocellular carcinoma(HCC)patients who underwent hepatectomy based on our preliminary study.METHODS:We examined relationships between MVC and clinicopathological factors in 128 HCC patients.The modified Japan Integrated Staging score(mJIS)was applied to examine subsets of HCC patients.RESULTS:Median MVC was 178/mm2,which was used as a cut-off value.MVC was not significantly associated with any Clinicopathologic factors or postoperative recurrent rate.Lower MVC was associated with poor disease-free and overall survivals by univariate analysis(P=0.039 and P=0.087,respectively)and lower MVC represented an independent poor prognostic factor in disease-free survival by Cox's multivariate analysis(risk ratio,1.64;P=0.024),in addition to tumor size,vascular invasion,macroscopic finding and hepatic dysfunction.Significant differences in disease free and overall survivals by MVC were observed in HCC patients with mJIS 2(P=0.046 and P=0.0014,respectively),but not in those with other scores.CONCLUSION:Tumor MVC appears to offer a useful prognostic marker of HCC patient survival,particularly in HCC patients with mJIS 2.