Two hundred and eighty-seven autopsy cases of hepatocellular carcinoma (HCC) in Chinese were reviewed. The analyses included histological study of the tumour and of the non-cancerous liver tissue, the cause of death and metastases. Bleeding of oesophageal varices was more frequent but rupture of tumour less common in cases associated with cirrhosis than in those without cirrhosis. There was a significantly higher incidence of bilobar involvement by tumour in the clear cell type of HCC and in cases unassociated with cirrhosis compared to other histological types of HCC and HCC with cirrhosis, possibly because of longer survival of the former groups. A strong association was found between cirrhosis and hepatic fibrosis with HCC and hepatitis B surface antigen (HBsAg), suggesting an oncogenic effect of chronic persistent hepatitis B virus (HBV) infection on hepatocytes.