The high expression of CTSA mRNA was related to the vascular invasion (P = 0.001), tumor TNM stage (P = 0.004), serum alpha-fetoprotein (AFP) level (P = 0.001), neoplasm histology grades (P = 0.038), and adjacent hepatic inflammation in (P = 0.009) HCC patients. This evidence concerns the gene AFP and neoplasm.