Abstract: Objective To observe the relationship between the level of total cholesterol (TC)，high-density lipoprotein (HDL)，apolipoprotein A-I (apoA-I) and the severity of postoperative sepsis in cancer patients. Methods This is a retrospective study. A total of 37 patients hospitalized in the surgery intensive care unit of the Third Affiliated Hospital of Sun Yat-Sen University from December 2010 to December 2011were enrolled in the study. All patients were divided into two groups according to the status after 28 days. The correlations between the lipoprotein and inflammatory cytokines, the independent predictive factor for sepsis were analyzied. Receiver-operating-characteristic curve (ROC) was used to evaluate the cut-off of TC, HDL, apoA-1 and APACHⅡas well as their predictive value for 28 days mortality. Results There was negative correlation between HDL, TC, apoA-1 and tumor necrosis factor-α(TNF-α)、 interleukin (IL-6) seperately; whereas these lipoprotein indexes didn't have significant correlation with neutrophil.The cut-off point of TC，HDL，apoA-I，APACHEII score were 1.46mmol/L，0.175mmol/L，0.525g/L，20.5 points. apoA-I has the highest diagnostic and predictive value. Conclusions The levels of TC, HDL, apoA-I can reflect the degree of inflammatory response to the postoperative sepsis and the severity of the disease in cancer patients. TC, HDL, apoA-I, APACHEII within 24hrs of sepsis have predictive value. But apoA-I was the highest diagnostic one.