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目的:肝细胞癌（HCC）是全球第4大、我国第2大癌症致死病因。随着人群代谢综合征(MS)发病率增高，MS与HCC的相关性逐渐被认识。MS在肝脏中表现为非酒精性脂肪性肝病（NAFLD，以下简称脂肪肝）。大量研究结果显示脂肪肝的发展与HCC的发生密切相关，脂质代谢在其中起到关键的调控作用，而脂质代谢又受脂肪酸结合蛋白（FABP）的调控，本研究详细分析HCC中脂代谢情况及关键FABP的表达情况及意义。方法:收集2016年1月至2019年7月首次诊断为原发性HCC患者资料，将数据根据病因分为两组，即病毒性肝炎相关HCC组和非病毒性肝炎相关HCC组，用n t检验及卡方检验分析MS相关因素与HCC的关系；免疫组织化学分别检测癌及癌旁组织中FABP1、FABP4、FABP5表达量，免疫荧光法检测合并脂肪肝HCC组织中FABP1、FABP4及FABP5的表达量，最后详细分析以上FABPs在不同临床病理特征HCC患者中的表达特点。n 结果:病毒性肝炎相关性HCC组与非病毒性肝炎相关HCC组间，脂质代谢异常率及MS相关因素异常数目差异有统计学意义；FABP1、FABP4、FABP5在HCC组织中表达低于对应癌旁组织，对比单纯HCC，伴脂肪变性HCC组织内FABP1、FABP4、FABP5增高，FABP的表达和患者临床特征密切相关。结论:脂代谢异常与非病毒性肝炎相关HCC密切相关，脂代谢调控蛋白FABP1、FABP4、FABP5的表达在HCC组织中表达下调，但在伴脂肪肝HCC中表达上升。提示临床中应重视MS特别是血脂异常与HCC的关系而进行早期干预，FABP1、FABP4、FABP5可能调控HCC的发生和发展。“,”Objective:Hepatocellular carcinoma (HCC) is the fourth most dominant cancer in the world and the second leading cause of cancer-related deaths in the China. With the increase in the incidence of metabolic syndrome (MS) in the population, the correlation between MS and HCC has gradually been recognized. MS manifests as non-alcoholic fatty liver disease (shortly known as NAFLD) in the liver. A large number of research results has shown that the development of fatty liver is closely related to the occurrence of HCC, in which lipid metabolism plays a key regulatory role, and lipid metabolism is regulated by fatty acid binding protein (FABP). This study signifies the lipid metabolism analysis and the key FABP expression conditions in HCC.Methods:Data of patients who were first diagnosed with primary HCC between January 2016 to July 2019 were collected, and were divided into two groups according to the etiology, namely the viral and non-viral hepatitis-related HCC group. The relationship between MS-related factors and HCC was analyzed by t-test and chi square test. The expressions of FABP1, FABP4 and FABP5 were detected in cancer and adjacent tissues by immunohistochemistry, and the expressions of FABP1, FABP4 and FABP5 in HCC with fatty liver were detected by immunofluorescence. Finally, the expressional characteristics of the above-mentioned FABPs in HCC patients were analyzed with different clinicopathological features.Results:There were statistically significant differences in the rate of abnormal lipid metabolism and the number of abnormalities in MS-related factors between the viral and non-viral hepatitis-related HCC group. FABP1, FABP4, and FABP5 expression in HCC tissues were lower than the corresponding adjacent tumor tissues. Compared with simple HCC, FABP1, FABP4, FABP5 expression were increased in HCC tissues with steatosis, and the expression of FABP was closely related to the clinical characteristics of patients.Conclusion:Abnormal lipid metabolism is closely related to non-viral hepatitis-related HCC. The expression of lipid metabolism regulatory proteins FABP1, FABP4, and FABP5 are down-regulated in HCC tissues, but up-regulated in HCC with fatty liver, suggesting that the relationship between MS, especially dyslipidemia, and HCC should be paid attention to in clinical practice for early intervention. FABP1, FABP4, FABP5 may regulate HCC occurrence and development.