Summary: Functional analysis reveals that the mutation in the hepatitis B virus X (HBx) gene is associated with hepatocellular carcinoma (HCC) malignancy. The mutation enhances HCC cell proliferation, invasion, and migration, while inhibiting apoptosis. It also promotes tumor growth and alters fibrosis, intracellular reactive oxygen species (ROS), and cytokine levels. The C1653T mutation may serve as a potential biomarker for screening HCC patients and determining the efficacy of apatinib treatment.