ObjectiveTo explore the relationship between the levels of transferrin (TRF), prealbumin (PAB) and total bile acids (TBA) in serum and the loss of the hepatic reserve function in primary liver cancer (PHC) patients and the importance of the former factors for diagnosis of PHC. MethodsA total of 154 patients with PHC collected between March 2010 and February 2013 were included in our study. Based on the information of hepatic reserve function and the Child-Pugh classification standard, the patients were divided into Child-Pugh-A, B, and C groups with 67, 55 and 42 patients respectively. Another 58 healthy subjects were selected as the control group. Serum TRF, PAB and TBA levels were measured by automated chemiluminescence immunoassay, immune turbidimetric assay and enzymatic cycling respectively, and they were compared among the groups. ResultsTRF level of patients in the control group and Child-Pugh-A, B, and C groups was respectively (2.574±0.214), (1.618±0.135), (0.988±0.121), and (0.314±0.107) g/L, with significant differences among the groups (P<0.05). PAB level of patients in four groups was respectively (269.32±37.29), (165.22±21.01), (123.24±31.15), and (83.66±19.74) mg/L, with significant differences among the groups (P<0.05). TBA level in the above four groups was respectively (9.16±2.48), (65.13±4.25), (133.62±8.44), and (250.73±21.59) μmol/L, and there was also significant differences among the groups. A positive correlation between serum TRF and PAB was found (r=0.927, P<0.001), and negative correlations between serum TBA level and serum TRF and between TBA and PAB were found (r=-0.454, P<0.001; r=-0.432, P<0.001, respectively). ConclusionSerum TRF, PAB and TBA levels are closely related to the hepatic reserve function in PHC patients, and they can be used as an important indicator for PHC diagnosis.