Objective:To explore the clinical value of serum miR-148a as a potential biomarker for hepatocellular carcinoma(HCC). Methods:Quantitative real-time polymerase chain reaction (qRT-PCR)was used to inrestigate the levels of serum miR-148a in HCC patients,the patients with benign liver diseases and healthy volunteers were used as control groups. Results:Serum levels of miR-148a were significantly decreased in HCC cases than those in benign and healthy controls,P < 0.001. Receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)in HCC group vs. benign group was 0.666,95% Confidence interval(CI),0.581-0.744;the diagnostic sensitivity was 67.7% and specificity was 59.2%,P < 0.001. The AUC in HCC group vs. healthy group was 0.746,95%CI,0.663~0.818;the diagnostic sensitivity was 43.6% and specificity was 96.1%,P < 0.001. In addition,serum miR-148a was significantly associated with tumor size (P=0.011) and TNM stage (P < 0.001),whereas,no significant correlation of serum miR-148a with other clinical parameters,P > 0.05. The level of serum miR-148a in postoperative HCC patients was significantly higher than that of preoperation,P=0.023. However,the level of serum miR-148a in postoperative patients with recurrence or metastasis was significantly decreased,and even lower than that of preoperative group,P < 0.05. Kaplan-Meier analysis demonstrated that the decreased serum miR-148a was closely correlated with shorten overall survival of HCC patients,P < 0.001. Besides,Cox regression model further indicated that serum miR-148a was an independent prognosis marker for HCC patients. Conclusion:The down-regulated serum miR-148 was related to disease condition,malignant progression and prognosis of HCC patients. Moreover,serum miR-148 might act as a potential marker for diagnosis and differential diagnosis,evaluation of disease,observation of curative effect and judgment of prognosis for HCC.