Furthermore, we have shown by multivariate analyses that patients with CTSL protein expression in carcinoma had a poor prognosis than those without CTSL expression, and that serum AFP, tumor size, tumor recurrence and stage and the status of CTSL protein were independent factors influencing overall survival, indicating that CTSL is a powerful prognostic index of survival in HCC. The gene discussed is AFP; the disease is hepatocellular carcinoma.