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Objective:To observe the association of the expression of peroxisome proliferator-activated receptor y (PPARy)with microvessel density (MVD) and vascularization mimicry (VM) in hepatocellular carcinoma (HCC) and explore their clinical significance.Methods:The expressions of PPARy and MVD and VM were tested by CD34 immunohistochemical (IHC) staining and periodic acid-Schiff (PAS) reaction in 34 cases of HCC tissues and its paired non-cancerous tissues.Their biological behaviors were analyzed and associated with the clinicopathological features.Results:PPARy was over-expressed (24/34)in HCC tissues.It was associated with tumor size (＞ 5 cm,P＝0.027),broken capsule (P＝0.014),tendency to metastasis and recurrence (P＝0.001).The MVD was higher (23/24) in HCC tissues than that in corresponding para-cancerous tissues (t＝18.925,P＜0.05).There was a significant positive correlation between the over-expression of PPARy and high MVD (r＝0.519).Kaplan-Meier analysis indicated that positive expression of PPARy and VM and high MVD could be used for predicating the survival rate of HCC patients (P＝0.013,0.036 and 0.022,respectively; log-rank test).Cox hazard model analysis showed that positive PPARy expression and high MVD were the independent prognostic factors for HCC.Conclusion:The PPARy correlated with the development of microcirculatory in HCC.PPARy is a novel prognostic indicator for evaluating of HCC.