Background/Aims: The development of human malignancies can be attributed to aberrant regulation of intracellular signal transduction pathways. In the current study, we aimed to evaluate focal adhesion kinase (FAK), a non-receptor tyrosine kinase, expression in hepatocellular carcinoma (HCC), and to explore the prognostic significance of FAK. Methods: We investigated FAK mRNA expression in 60 HCC specimens using quantitative real-time reverse transcription polymerase chain reaction analysis, and the correlation between FAK expression and clinicopathologic parameters. FAK protein expression was examined using Western blot analysis and an immunohistochemical study. Results: We found that FAK mRNA was overexpressed in HCCs compared with the corresponding non-cancerous liver tissues (P = 0.0008). The FAK overexpression correlated significantly with tumor size (P = 0.034) and serum AFP level (P = 0.030). Univariate and multivariate analyses revealed that FAK mRNA expression was an independent prognostic factor for disease-free (risk ratio 3.83; P = 0.024) and overall (risk ratio 7.14; P = 0.015) survival. Besides, we confirmed immunohistochemically that the FAK protein was detectable in cancer cells despite non-expression in corresponding non-cancerous tissues. Conclusions: Our results suggest that FAK mRNA expression has prognostic significance for the survival of patients with HCC. (C) 2004 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.