HCC patients with high qualitative and quantitative expression of α-SMA revealed a statistically significant negative correlation with 3-year [odds ratio (OR), 0.021 and 0.111; P=0.001 and 0.0302, respectively] and 1.5-year (OR, 0.040 and 0.051; P=0.0330 and 0.0492, respectively) survival rates in comparison with low expression. This evidence concerns the gene ACTA1 and hepatocellular carcinoma.