Objective To explore the significance of prognostic nutritional index PNI and serum soluble urokinase - type plasminogen activator receptor suPAR and thymidine kinase 1 TK1 in the expression of advanced hepatocellular carcinoma and its role in prognostic evaluation. Method A retrospective analysis was conducted on 92 patients with advanced liver cancer collected from February 2019 to February 2021 all of whom underwent PNI evaluation and serum suPAR and TK1 detection. The levels of PNI suPAR and TK1 were compared between the two groups. At the same time based on whether the patient died they were divided into a poor prognosis group n = 28 death and a good prognosis group n = 64 survival . After analyzing the independent risk factors affecting the prognosis of advanced liver cancer patients using a multi factor Cox risk model the diagnostic value of PNI suPAR and TK1 was analyzed using receiver operating characteristic ROC curves. Result Through univariate analysis vascular invasion and portal vein thrombosis can have an impact on the prognosis of advanced liver cancer P < 0. 05 and the PNI index of the poor prognosis group is lower than that of the good prognosis group while the levels of suPAR and TK1 are higher than those of the good prognosis group with statistically significant differences. Kaplan Meier survival analysis showed that patients with high expression of PNI low expression of suPAR low expression of TK1 no vascular invasion and no portal vein thrombosis had significantly higher survival time than those with low expression of PNI high expression of suPAR high expression of TK1 vascular invasion and portal vein thrombosis with statistical significance P<0. 05 According to the multi factor Cox risk model analysis low expression of PNI high expression of suPAR and high expression of TK1 are independent risk factors affecting the prognosis of advanced liver cancer patients P<0. 05 . According to ROC curve analysis the area under the curve for PNI suPAR TK1 and the combined diagnosis of advanced liver cancer prognosis were 0. 818 0. 827 0. 801 and 0. 957 respectively. Conclusion As serum suPAR and TK1 levels increased PNI index decreased prognosis nutrition index suPAR and TK1 can be used as a simple and effective index to help evaluate the severity and prognosis of patients with advanced HCC.