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AIM: To investigate the expression of COX-2 proteins in gastric mucosal lesions and to assess the relationship between COX-2 expression and type, pathologic stage,differentiation, or lymph node metastasis in gastric cancer and the relationship between COX-2 expression and Hpylori infection in gastric mucosal lesions.METHODS: Thirty patients with gastric carcinoma underwent surgical resection. Samples were taken from tumor site and paracancerous tissues, and ABC immunohistochemical staining was used to detect the expression of COX-2 proteins. Hpyloriwas determined by rapid urea test combined with pathological stating/14 Curea breath test.RESULTS: The positive rate and staining intensity of mutant COX-2 gene expression in gastric cancer were significantly higher than those in paracancerous tissues (66.7% vs 26.7%)(P＜0.01, P＜0.001). There was a significant correlation between COX-2 and pathologic stage or lymph node metastasis type of gastric carcinoma (76.0% vs 20.0%, 79.2% vs 16.7%)(P＜0.05). No correlation was found between COX-2expression and type or grade of differentiation (P＞0.05).COX-2 expression of intestinal metaplasia (IM) or dysplasia(DYS) with positive H pylori was significantly higher than that with negative H pylori(50.6% vs 18.1%, 60.0% vs33.3%) (P＜0.05).CONCLUSION: COX-2 overexpression was found in a large proportion of gastric cancer tissues compared with matchednon-cancerous tissues and was significantly associated with advanced tumor stage and lymph node metastasis.Overexpression of COX-2 plays an important role in tumor progression of gastric cancer. COX-2 may also play a role in the early development/promotion of gastric carcinoma and is associated with H pyloriinfection.