**1. Introduction**

Aflatoxin B1 (AFB1) is a knowledge I-type chemical carcinogen for primary hepatocellular carcinoma (PHCC) [1–3]. This carcinogen is mainly produced by *Aspergillus parasiticus* and *Aspergillus flavus* and often found in crops and food (including maize, nuts, and beans), which are raised in the areas with humid and hot environment [1, 4, 5]. Once these AFB1-contaminated crops and food are ingested by human bodies, AFB1 will be metabolized through two stage reactions consisting of detoxification stage (such as reduction, oxidation, and hydrolytic reaction) and covalent stage (such as binding reaction and conjugating reaction) [2, 3]. During the process of AFB1's metabolism, AFB1- DNA adducts, including AFB1-formamidopyrimidine adduct (AFB1-FAPa) and AFB1's 8,9-dihydro-8-(N<sup>7</sup> -guanyl)-9-hydroxy–adduct (AFB1-GA), are frequently formed [2, 3]. Growing evidence has shown that AFB1-DNA adducts are usually tested in the tissue samples (such as liver and placenta tissues) of these individuals from high AFB1 exposure areas [6–10]. Recent studies have displayed that they are also found in the peripheral blood white cells of peoples who are from high AFB1 exposure areas and are associated with the time of AFB1 exposure [11–17]. However, the potential of blood AFB1-DNA adducts predicting PHCC risk and prognosis is not clear. Here, we specifically conduced a hospital-based case-control study to investigate whether blood AFB1-DNA adducts were related to the risk and outcome of PHCC.
