Background Although excellent guidelines relating to the clinical management of gastric cancer are available,these generally do not include any mention of conventional tumor markers like carcinoembryonic antigen (CEA) expressionsin gastric cancer tissues.The aim of this study was to evaluate the prognostic benefit of negatively stained tissueCEA in a larger cohort of patients with gastric cancer than previously reported.Methods About 1509 patients with histologically proven gastric cancer who underwent curative D2 gastreetomy between 2001 and 2010 were evaluated at the Sun Yat-sen University Cancer Center in search forcorrelation between negatively stained gastric cancer tissue, clinocopathological characteristics and prognostic significance.Results Statistically significance of the negative expression of CEA in the gastric cancer tissue was found in relation to serum CEA (p=0.031), depth of invasion (p≤0.001), lymph node metastasis (p≤0.001), distant metastasis (p≤0.001) and to the AJCC 7th edition TNM staging (p≤0.001).Multivariate analysis of prognostic factors with Cox stepwise proportional hazard model showed that except for tumor size (HR 1.105; p=0.255) and histological type (HR 1.020; p=0.794); age (HR 1.405; p≤0.001), tumor location (HR 0.834; p=0.012), venous/lymphatic invasion (HR 1.440; p=0.005), tumor depth (HR 1.548; p≤0.001), nodal status (HR 1.573; p≤0.001), distant metastasis (HR 2.905; p=0.005), tCEA (HR 1.277; p=0.005) and sCEA (HR 1.202; p=0.047) were important independent prognostic factors.Thus, it was shown that the 5-year survival rate of patients with negatively stained, slightly stained and intensively stained gastric cancer tissue CEA was 67.6%, 53.9% and 40.1% respectively.Conclusion The negative expression of CEA in resected gastric cancer tissues is shown to be a useful biomarker to predict the prognosis after curative resection of gastric cancer.