Clinicopathological features were evaluated according to the expression of ERα, which revealed that compared to ERα (−) HCCs, ERα (+) HCCs, were significantly associated with older age (>60 years, p < 0.05, Student’s T-test), lower serum AFP levels (3.6 IU/mL, p < 0.001, Student’s T-test), a lower incidence of tumor microvascular invasion (38%, 12/32, p = 0.029, Fisher’s exact test), and a higher incidence of fatty change in the tumor (46.9%, 15/32, p = 0.017; Table 1). Here, AFP is linked to neoplasm.