中医治疗慢性萎缩性胃炎的探讨

对于慢性萎缩性胃炎从整体出发进行辩证论治，结合微观胃粘膜病理特点对有关几个问题进行讨论．1辨证施治将慢性萎缩性胃炎分为脾胃虚弱、脾胃虚寒、肝胃不和、脾胃湿热、胃阴虚等型．慢性萎缩性胃炎有癌变可能，学术界把胃癌前病变作为胃粘膜研究的重点，运用中药治疗可以使胃粘膜腺体萎缩得到逆转，“重建”．2中医治疗慢性萎缩性胃炎有关几点①辨症和辨病相结合：由于慢性萎缩性胃炎有时缺少特异症状，因此，尚须在辨证的基础上与辨病内镜及病理切片相结合．②慢性萎缩性胃炎病理检查常出现肠腺化生和不典型增生，中医认为均有瘀滞表现，宜用活血化瘀的药物，通过改善微循环使病变的粘膜和腺体得到充分灌注，加快损伤的修复③关于幽门螺杆菌（Hp）：中草药如黄连、黄芩、大黄等Hp有抑制与杀灭作用．④关于慢性萎缩性胃炎伴胆汁反流：胆汁反流中医认为与脾气虚，肝气郁结有关，所以采用健脾和胃，疏肝降逆药物治疗．⑤临床用药的注意点：胃弱者不胜重药忌重投大苦大寒，滋腻壅中，香燥破气之品．

慢性萎缩性胃炎患者血浆cAMPcGMP水平的变化

目的本文旨在研究慢性萎缩性胃炎患者脾气虚证与血浆ｃＡＭＰ与ｃＧＭＰ的关系．方法对８７例萎缩性胃炎有脾气虚证者以碘１２５标记的ｃＡＭＰ与ｃＧＭＰ药盒采用免疫化学法测定其血浆ｃＡＭＰ与ｃＧＭＰ，其中３０例在萎胃安冲剂１—２疗程前后作自身对照，观察其血浆浓度变化．结果所有脾气虚证的萎缩性胃炎患者，血浆ｃＡＭＰ与ｃＧＭＰ分别为低与正常低限．３０例萎胃安冲剂治疗者，其血浆ｃＡＭＰ与ｃＧＭＰ均较治前增高，Ｐ值分别为＜００１与＜００５，有统计学意义．结论对萎缩性胃炎脾气虚患者，测定其血浆ｃＡＭＰ与ｃＧＭＰ水平有重要意义．萎胃安冲剂可改善其症状，纠正血浆ｃＡＭＰ低下状态．

戊己胶囊治疗慢性萎缩性胃炎临床研究

目的观察中药戊己胶囊对慢性萎缩性胃炎的治疗效果方法慢性萎缩性胃炎患者100例，应用戊己胶囊（柴胡、白术、佛手、蒲公英等9味药组成）进行治疗．其中轻度萎缩性胃炎42例，中度38例，重度20例，伴肠腺化生41例．Ⅰ°不典型增生13例、男63例，女37例.年龄30岁～65岁，平均51岁±8岁，病程6mo～100mo，平均60．0mo±18．5mo．临床表现胃脘病者86例，胃脘胀满72例，纳呆90例，嗳气34例，口苦20例．连用3mo后，对患者的临床症状、胃粘膜的改善情况进行比较分析．结果经戊已胶囊治疗3mo，临床治愈7例，显效48例，有效34例，无效11例，愈显率55．0％，总有效率为89．0％．轻度萎缩性胃炎42例中有33例转为浅表性胃炎，4例恢复正常，5例无变化；中度萎缩性胃炎38例中间例转为轻度萎缩性胃炎，14例转为浅表性胃炎，3例恢复正常，4例无变化；重度萎缩性胃炎20例中10例转为中度萎缩性胃炎，8例转为浅表性胃炎，2例无变化．肠腺化生轻度26例中消失20例，无变化6例；中度8例，转为轻度化生4例，消失1例，3例无变化；重度7例中有2例转为中度，2例转为轻度化生，3例无变化Ⅰ°不典型增生13例中有7例恢复正常，6例无变化结论戊己胶囊对慢性萎缩性胃炎有良好的治疗作用，对气滞型和虚寒型疗效相同．

505神功元气袋治疗萎缩性胃炎57例

目的观察505神功元气袋对慢性萎缩性胃炎的治疗效果．方法慢性萎缩性胃炎患者57例佩戴505元气袋（含西洋参、虫冬夏草、三七等50多味中药）治疗6mo．男31例，女26例，年龄19岁～70岁．分单纯戴带组32例（其中20岁～30岁5例，31岁～50岁17例，51岁以上10例）；单纯服药组14例；戴带加服药组11例．治疗前后均做内镜、病理活检及Hp检测．为便于对照，取材标本固定部位并标准化，Hp检测采用HpUT半定量试剂盒．上述检查分别由同一人操作．后两组患者中部分患者伴有溃疡病，糜烂性胃炎及重度十二指肠炎的患者，常规用雷尼替丁4wk，对Hp检测阳性者以剂、甲硝唑、庆大霉素口服2wk．对照组中的单纯萎缩性胃炎仅用维霉素及喉头菌6mo．对全部患者以调查问卷形式观察治疗前后及治疗过程中的临床症状、体征诸如食欲、嗳气、泛酸、呕吐、体重、大便等变化．结果经用505元气袋治疗6mo后提示，单纯戴带组与单纯服药组疗效基本一致（P＞0．05），戴带加服药组疗效明显优于单纯戴带组（P＜0．05），亦优于单纯服药组，但统计学处理无意义．戴带加服药组在症状，体征改善方面要快，溃疡及糜烂面的愈合期缩短1wk～2wk．单纯戴带组32例中，疗效与年龄、性别无明显相关性，对症状、体征的总有效率达70％以上。

慢性萎缩性胃炎与唾液酸关系的探讨

目的对慢性萎缩性胃炎与唾液酸关系进行初步探讨．方法分别选择慢性萎缩性胃炎、浅表性胃炎、健康人群30，30，80例进行血清唾液酸的测定．具体方法为：首先空腹抽取外周静脉血1mL于普通试管中，然后加入成都军区总医院研制的F－8836TSA专用试剂4mL后，放在沸水中水浴20min．再经3000r／min离心5min，以上清液560nm比色．以空白调零测定及记录OD值，计算血清TSA含量（mmol／L）＝样品OD值／标准品OD值×1．62．正常参考值：1．42mmol／L－2．11mmol／L，血清TSA值超过2．11mmol／L者定为阳性．结果慢性萎缩性胃炎、浅表性胃炎、健康人群三组血清唾液酸阳性率分别为50％，10％，5％，经卡方检验几组结果阳性率之间有显著性差异（P＜0．05），其中萎缩性胃炎与浅表性胃炎比较x2＝0．01，P＜0．01有极显著性差异．而且，在一些慢性萎缩性胃炎患者中TSA保持较高的水平，且有6例病理已确诊为伴肠化，提示应该对慢性萎缩性胃炎患者定期进行唾液酸检测，从而了解慢性萎缩性胃炎病情发展情况，指导治疗．结论慢性萎缩性胃炎与唾液酸存在一定的关系，应对该类患者进行唾液酸的定期检测，以便早期发现胃癌患者，及早治疗．

胃得安与猴菇菌片治疗慢性萎缩性胃炎的对比研究

目的观察胃得安对慢性萎缩性胃炎（CAG）的治疗效果．方法经内镜及病理学确诊的CAG患者152例，随机分为2组，治疗组102例中，男性62例，女性40例，年龄46岁±5．7岁，病程7．5a±2．1a．病变位于胃窦者80例，在胃体者11例，胃窦及胃体皆有者11例，Hp阳性者80例，口服胃得安（由苍术、白术、紫河车、砂仁等14味中药组成），疗程为3mo，对照组50例中，男性32例，女性18例，年龄45岁±8岁，病程6．5a±2．3a，病变位于胃窦者33例，胃体者17例，Hp阳性者28例，口服猴菇菌片，疗程为3mo．用药前后，对所有病例的临床症状、内镜下胃粘膜病变、肠腺化生、不典型增生及Hp感染情况进行比较，并在2组间进行比较分析．结果临床症状总有效率为：治疗组95．2％，对照组55％．2组比较有显著性差异（P＜0．05）．治疗前2组病例胃粘膜均有明显的红白相间及较大的苍白区、粘膜变薄及纤维化、粘膜下血管明显显露，疗程结束后，治疗组上述病变的消失率分别为85．2％（69／81），66．6％（60／90），73．3％（22／2），对照组上述病变的消失率分别为22．8％（8／35），20％（9／45），29．4％（5／17）．2组比较，治疗组均明显高于对照组（P均＜0．01）．治疗组胃得安对肠腺化生及不典型增生的总有效率分别为60．

胃苏冲剂治疗慢性蒌缩性胃炎43例

目的观察胃苏冲剂对慢性萎缩性胃炎的治疗效果．方法慢性萎缩性胃炎43例，男28例，女15例，年龄32岁～65岁，病程2mo～19a．临床表现为：腹痛36例，腹胀35例，食欲不振32例，嗳气32例，上肢不适21例，全身乏力9例，消瘦4例．轻度萎缩性胃炎23例，中度14例，重度6例，肠上皮化生8例，不典型增生2例．服用胃苏冲剂（主要成分为紫苏梗、香附、陈皮、佛手等）3mo后观察疗效．结果疗程结束后，腹痛有效率为94．4％，腹胀有效率为97．1％，食欲不振有效率为90．6％，嗳气有效率为96．9％，上腹不适有效率为76．2％，全身乏力有效率为77．8％，消瘦有效率为50．0％23例轻度萎缩性胃炎中15例转为浅表性胃炎，14例中度萎缩性胃炎中12例转为轻度，6例重度萎缩性胃炎中5例转为中度，总有效率为74．4％．8例肠上皮化生中3例消失，2例不典型增生无变化，未发生不良反应．结论胃苏冲剂可促使萎缩胃粘膜逆转，对慢性萎缩性胃炎有良好的治疗作用．

慢性萎缩性胃炎患者肠道菌群特征

目的探讨不同炎症程度慢性萎缩性胃炎(CAG)患者肠道菌群特征,为该类患者的治疗提供参考。方法对36例健康人(健康对照组)和8例轻度炎症(轻度炎症组)、26例中度炎症(中度炎症组)、8例重度炎症(重度炎症组)的CAG患者的粪便样本进行16S rRNA基因高通量测序(V4—V5区),采用Sobs、Shannon、Simpson、Ace、Chao指数评估4组对象肠道菌群的物种丰富度与多样性;采用PLS-DA分析评估4组对象肠道微生物群落结构;采用LDA与LEfSe分析确定4组对象相对丰度存在显著差异的肠道菌群;采用PICRUSt预测CAG患者显著富集肠道菌属的代谢通路信息。结果与健康对照组相比,轻、中、重度炎症组患者肠道菌群Sobs、Ace、Chao、Simpson指数有降低趋势,但差异均无统计学意义(均P>0.05)。Ruminococcus_gnavus_group、norank_f_Ruminococcaceae、Erysipelatoclostridium、Actinomyces在轻度炎症组中显著富集,Flavonifractor、Sellimonas在中度炎症组中显著富集,Eubacterium_rectale_group、Erysipelotrichaceae_UCG-003、Tyzzerella_3、Coprococcus_1、Candidatus_Soleaferrea在重度炎症组中显著富集。此外,Lachnospiraceae_UCG-004、Eubacterium_nodatum_group的丰度在健康对照组、轻度炎症组、中度炎症组、重度炎症组中呈递增趋势;Anaerostipes、Ruminiclostridium_9、Halomonas、Pelagibacterium的丰度在健康对照组、轻度炎症组、中度炎症组、重度炎症组中呈递减趋势,但差异均无统计学意义(均P>0.05)。PICRUSt分析结果显示4组对象肠道菌群代谢通路相似,但是代谢通路的丰度不同,其中重度炎症组患者肠道菌群代谢功能潜力高于健康对照组、轻度炎症组和中度炎症组。结论CAG患者肠道菌群变化的总体特征为产丁酸盐的菌属丰度减少,促炎菌属的丰度增加。促炎菌属可能通过附着于肠道上皮导致黏膜屏障受损和肠道通透性增加,影响宿主免疫反应,引起炎症。

慢性萎缩性胃炎大鼠模型的建立及稳定性评价

目的:建立一种慢性萎缩性胃炎大鼠模型并对其稳定性进行评价。方法:采用去氧胆酸钠溶液自由饮用,同时配合酒精灌服复制大鼠慢性萎缩性胃炎,以胃组织病理诊断结果为评价标准;模型复制成功的大鼠随机分为模型恢复组、维酶素片对照组,常规饲养30天,以胃组织病理学、扫描电镜、胃肠激素分泌功能、胃微循环血流量等指标评价模型稳定性。结果:造模100天后,成功复制大鼠萎缩性胃炎模型,模型复制成功率75%;恢复期30天内,大鼠萎缩性胃炎病理变化相关指标保持稳定。结论:去氧胆酸钠配合酒精刺激100天成功复制大鼠慢性萎缩性胃炎模型并在30天内保持稳定,适用于药物药效学的评价及临床基础研究。

胃窦部隆起性病变36例

目的通过对内镜检查出的36例胃窦部隆起性病变进行分析，探讨其病因及意义方法36例全部经内镜检出并得到病理证实．结果胃窦低分化腺癌6例，慢性萎缩性胃炎伴肠化10例，慢性萎缩性胃炎伴异型增生6例，慢性轻度萎缩性胃炎8例，慢性浅表性胃炎4例，胃窦部嗜酸性肉芽肿2例．结论胃窦部是癌肿、息肉及炎症之好发部位，对内镜检出的隆起性病变更要注意恶性变的可能因为胃窦部萎缩性胃炎与胃窦癌的关系密切，特别对年龄在50岁以上者，一旦诊断为恶性病变或癌前病变即应积极采取必要措施进行治疗．

Risk for gastric neoplasias in patients with chronic atrophic gastritis:A critical reappraisal

Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.

Effects of Helicobacter pylori eradication on atrophic gastritis and intestinal metaplasia: A 3-year follow-up study

AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P＜0.01). However, the grade of IM increased in H pylori -infected group (P＜0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.

Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal,healthy stomach

AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.e.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.

Potential therapeutic significance of increased expression of aryl hydrocarbon receptor in human gastric cancer

AIM： To determine the functional significance of aryl hydrocarbon receptor （AhR） in gastric carcinogenesis, and to explore the possible role of AhR in gastric cancer （GC） treatment. METHODS： RT-PCR, real-time PCR, and Western blotting were performed to detect AhR expression in 39 GC tissues and five GC cell lines. AhR protein was detected by immunohistochemistry （IHC） in 290 samples： 30 chronic superficial gastritis （CSG）, 30 chronic atrophic gastritis （CAG）, 30 intestinal metapiasia （IN）, 30 atypical hyperplasia （AH）, and 70 GC. The AhR agonist tetrachlorodibenzo-para-dioxin （TCDD） was used to treat AGS cells. MTr assay and flow cytometric analysis were performed to measure the viability, cell cycle and apoptosis of AGS cells.RESULTS： AhR expression was significantly increased in GC tissues and GC cell lines. IHC results indicated that the levels of AhR expression gradually increased, with the lowest levels in CSG, followed by CAG, IM, AH and GC. AhR expression and nuclear translocation were significantly higher in GC than in precancerous tissues. TCDD inhibited proliferation of AGS cells via induction of growth arrest at the G1-S phase. CONCLUSION： AhR plays an important role in gastric carcinogenesis. AhR may be a potential therapeutic target for GC treatment.

Morphological and pathologic changes of experimental chronic atrophic gastritis (CAG)and the regulating mechanism of protein expression in rats

Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods： Rats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis （CAG） models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin （H-E） and alcian blue （A-B） stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer （μm） and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope （SEM）. The levels of PGE2, EGF （epiderminal growth factor） and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR （EGF receptor）, C-erbB-2, p53, p6 and bcl-2 in gastric tissue. Results： Under SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower （P〈0.05）. Compared with normal level of （0.61±0.28） μg/L, EGF in CAG （2.24±0.83） μg/L was significantly higher （P〈0.05）. The levels of PGEz and gastrin in serum were significantly lower in CAG rats than that in normal rats （P〈0.05）. Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group （P〈0.05）. Imrauno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p 16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue, bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue. Conclusion： The pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.

Influence of H pylori on plasma ghrelin in patients without atrophic gastritis

AIM:To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS:Fifty consecutive patients(24 males and 26 females)with either H pylori-positive gastritis(n = 34)or H pylori-negative gastritis(n = 16)with normal gastric acid secretion determined by 24-h pHmetry and without atrophic gastritis in histopathology were enrolled in this study.Thirty-four H pylori-infected patients were treated with triple therapy consisting of a daily regimen of 30 mg lansoprazole bid,1 g amoxicillin bid and 500 mg clarithromycin bid for 14 d,followed by an additional 4 wk of 30 mg lansoprazol treatment.H pylori infection was eradicated in 23 of 34(67.6%)patients.H pylori-positive patients were given eradication therapy.Gastric acidity was determined via intragastric pH catethers.Serum ghrelin was measured by radioimmunoassay(RIA).RESULTS:There was no signifficant difference in plasma ghrelin levels between H pylori-positive and H pylori-negative groups(81.10 ± 162.66 ng/L vs 76.51 ± 122.94 ng/L).In addition,there was no significant difference in plasma ghrelin levels and gastric acidity levels measured before and 3 mo after the eradication therapy.CONCLUSION:H pylori infection does not influence ghrelin secretion in patients with chronic gastritis without atrophic gastritis.

Effects of He-Ne laser irradiation on chronic atrophic gastritis in rats

AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG)model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24J/cm2doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter,the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope.RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P＜0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P＜0.01), the gastric mucosal inflammation cells were decreased (P＜0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal.CONCLUSION: 3.36J/cm2 dose of He-Ne laser has a significant effect on CAG in rats.

Significance of serum tumor markers CA50 and CEA in gastric cancer

AIMS The CAS0 and CEA are well-described human tumor-as- sociated antigens most useful clinically in gastrointestinal cancer. In this study we compared these markers in sera from patients with malignant and benign digestive tract diseases. METHODS Using a side-phase radioimmunoassay,CA50 and CEA serum levels were measured in 33 control subjects and 86 patients with gastric cancer(n=34),gastric ulcer(n=27)and chronic atrophic gastritis(n=25).Carcinoma of the stomach was found in the antrum(n=22),in the body(n=3),and the fundus(n=9),and histopathologically,was divided into adeno- carcinoma(n=21),squamous cancer(n=4)and not divided (n=9).Gastric ulcer,when present,appeared in the antrun(18 patients),the body(3)and the fundus(9)and chronic atrophic gastritis was all associated with intestinal metaplasia(IM). RESULTS The normal ranges established for CA50 and CEA in the control group were 16.26+6.14 kU/L and 3.12±1.03/μg/L respectively.In the patients with gastric cancer,serum levels of CA50(112.67±38.36 kU/L)and CEA(10.28±3.76μg/L) were elevated significantly(P<0.01,respectively),the former being>22 kU/L in 18 of 34 patients(53%;range,5-1 550 kU/ L),and the latter>5 μg/L in 19 of 34 patients(55.8%,range, 0.5-17.4 μg/L).A statistically significant correlation was found between the levels of CA50 and GEA(r=0.648,P<0.01). The serum levels of CA50(46.4±25.9 kU/L,P<0.01 )and CEA(6.85±2.43 μg/L,P<0.01)were much lower in patients with gastric ulcer or chronic atrophic gastritis(P>0.05). CONCLUSIONS Based on these results,it is concluded that CA50 and CEA are indicators for advanced gastric cancer,and af- ter surgery,their serum levels may decrease considerably. Overall,there is such a close correlation between them that in clinical practice they might be of great value to the diagnosis of gastric cancer.