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Background Loss of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) expression is an adverse prognostic factor in hepatocellular carcinoma (HCC).The purpose of this study was to investigate the expression of CEACAM1 and its effect on relapse-free survival (RFS) following liver transplantation (LT) for HCC.Methods Expression of CEACAM1 was immunohistochemically detected in HCC specimens from 48 patients.The relationship between CEACAM1 expression and clinicopathologic variables,as well as tumor recurrence,was further analyzed.Results Of the 48 HCC specimens,membranous CEACAM1 expression was detected in 25 specimens and cytoplasmic CEACAM1 expression was detected in 19 specimens.Four specimens had loss of CEACAM1 expression.Loss of membranous CEACAM1 expression was significantly associated with tumor size,tumor number,and serum α-fetoprotein levels (all P ＜0.05).Patients with loss of membranous CEACAM1 had significantly poorer RFS than patients with membranous expression,determined via Kaplan-Meier analysis (P=0.027).Multivariate analysis revealed that loss of membranous CEACAM1 expression might be an independent prognostic factor of RFS for HCC patients after liver transplantation (P=0.037).Conclusion Loss of membranous CEACAM1 expression in HCC was closely associated with aggressive tumor biology and might be a relapsing biomarker of HCC treated with LT.