H epatocellular carcinoma (HCC) is one of the most common and aggressive malignant tumors worldwide. The longterm prognosis of HCC patients has remained unsatisfactory due to the high incidence of intrahepatic recurrence, which depends on portal venous invasion and the high incidence of intrahepatic metastasis, as well as multicentric development of new tumors.(1,2) Moreover, our understanding of the molecular mechanisms underlying the progression of HCC and the development of effective therapeutic targets remain to be studied in further detail.One candidate among the many growth factors that are closely associated with growth of HCC cells is insulin-like growth factor (IGF).(3) The biological effects of IGF are mediated via type 1 IGF receptor (IGF-1R), which leads to activation of the mitogenactivated protein kinase (MAPK) signaling pathway involved in cell growth and metabolism.(4,5) Mutation of another type 2 receptor (M6P/IGF-2R) and upregulation of IGF-II are expected to be responsible for the early stages of human hepatocarcinogenesis. (6,7) However, it remains unclear how the IGF system is involved in the progression of HCC. IGF are known to bind to IGF binding proteins (IGFBP), which regulate activity and function of IGF. (8) IGFBP-3 is the most abundant IGFBP that is present in non-cancerous liver tissues and serves as a negative regulator of cell proliferation in human HCC.(9-12) IGFBP-3 is also known to regulate cell growth independently of its effects on IGFstimulated growth in other types of malignancy. (13)(14)(15)(16) In our present study, we investigated how IGFBP-3 exerts its antiproliferative effects on HCC cell lines in culture, and using immunohistochemical analyses we further examined whether or not the expression of IGFBP-3 in human clinical samples is associated with the clinicopathological characteristics of HCC. We discuss plausible roles of IGFBP-3 in the IGF-dependent and -independent cell proliferation of HCC, and also the clinical significance of IGFBP-3 in patients with HCC.