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Background Hepatitis B virus infection is closely related to hepatocellular carcinoma (HCC).Cyclooxygenase-2 (COX-2) is overexpressed in HCC and considered to play a role in hepatic carcinogenesis.In this study,we analyzed the polymorphism of COX-2 promoter -899G/C in healthy controls,chronic hepatitis B (CHB) patients,liver cirrhosis patients,and hepatocellular carcinoma (HCC) patients,to investigate the relationship between COX-2 -899G/C polymorphism and the risk for hepatitis B-related liver cancer in a Chinese population from Gansu province.Methods Patients were divided into four groups:300 patients with CHB,300 patients with liver cirrhosis,300 patients with HCC,and 300 healthy controls.The polymorphism of COX-2 -899G/C was detected by PCR-TaqMan probes.The results were analyzed by SPSS 17.0.Results The COX-2 -899G/C genotypes were GG,GC,and CC.Frequencies in CHB were 87.00％,12.67％,0.33％; in liver cirrhosis were 85.33％,14.00％,0.67％; in HCC were 77.00％,21.67％,1.33％; and in healthy controls were 90.67％,9.00％,0.33％,respectively.COX-2 -899C carriers may have an increased risk for hepatitis B-related liver cancer.Compared with the frequency of GG genotype,there were significant differences in the frequency of GC genotype between HCC and healthy control groups (OR=2.835,95％Cl:1.751-4.589); HCC and CHB groups (OR=1.933,95％Cl:1.248-2.994); and HCC and liver cirrhosis groups (OR=1.175,95％Cl:1.119-2.628).Stratification analyses showed that COX-2 -899C allele carriers with a drinking history are more susceptible to develop HCC.Conclusion COX-2 -899C genotype may increase the susceptibility of individuals to hepatitis B-related liver cancer in Gansu province,China.