Objective To investigate the changes of serum miR-21 expression level in patients with HCC before and after transcatheter arterial chemoembolization (TACE) and to discuss its clinical significance. Methods Before and after TACE the levels of serum miR-21 in 42 patients with HCC and 42 healthy subjects were determined by reverse transcriptase quantitative PCR (RT-PCR), and the levels of serum AFP were also estimated by enzyme-linked immunosorbent assay (ELISA). The results were analyzed. Results The serum miR-21 level in patients with HCC was (12.9 ± 3.5) times of that in normal subjects(t=19.430 7, P < 0.01). One month after TACE, the serum miR-21 level became (7.2 ± 1.7) times of that of normal reference value, which was remarkably lower than that obtained before the treatment (t=9.493 7, P<0.01). The serum miR-21 level was closely correlated with the tumor size, the presence of tumor thrombus and HBV infection. One month after TACE the serum miR-21 levels in patient groups showing partial response, stable disease and progressive disease were (4.0 ± 0.3), (6.0 ± 1.5) and (8.6 ± 1.5) times, respectively, of that of normal reference value, and statistically significant difference existed between each other among the three groups (F=38.168, P=0.000). ROC-AUC value of MiR-21 in diagnosing HCC was 0.910 ± 0.041, which was significantly higher than that of AFP (0.860 ± 0.037, t=6.3042, P<0.01). The specificity of miR-21 in detecting HCC was 88.1%, which was remarkably higher than that of AFP (69%, χ2= 4.5253, P = 0.033).Conclusion After TACE the serum MiR-21 level in HCC patients is significantly decreased, which is very helpful in predicting the therapeutic efficacy of TACE. Therefore, MiR- 21 can be regarded as a potential molecular marker of HCC.%目的：探讨HCC患者经皮肝动脉化疗栓塞（TACE）术前、后血清miR-21表达变化及临床意义。方法以反转录定量PCR（RT-PCR）法检测HCC患者TACE术前、后及正常者血清miR-21水平，以酶联免疫吸附法（ELISA）检测血清AFP水平。结果 HCC患者血清miR-21水平为正常人的（12.9±3.5）倍（t =19.4307，P <0.01），TACE 术后1个月为正常参考值的（7.2±1.7）倍，较术前显著降低（t =9.4937，P<0.01）。血清 miR-21水平与肿瘤大小、癌栓及HBV感染相关。TACE术后1个月血清miR-21水平在部分缓解、稳定和进展组中分别为正常人的（4.0±0.3）、（6.0±1.5）和（8.6±1.5）倍，各组间差异有统计学意义（F=38.168，P=0.000）。 miR-21诊断HCC的ROC-AUC值为0.910±0.041，显著高于AFP的0.860±0.037（t=6.3042，P<0.01）。 miR-21检测HCC的特异度（88.1%）显著高于AFP（69.0%，χ2=4.5253，P=0.033）。结论 TACE 术后miR-21水平明显降低，能较好预测TACE 术疗效，是HCC的潜在分子标记物。
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