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目的:研究胃癌患者肿瘤标志物表达情况与行根治性切除的关系。方法:回顾性分析2018年6月至2019年12月于南方医科大学附属东莞市人民医院普济院区胃肠外科接受手术治疗的胃癌患者的病历资料，最终筛选入组136例。收集患者资料，包括一般资料，肿瘤标志物癌胚抗原(carcinoembryonic antigen，CEA)、糖链抗原19-9(carbohydrate antigen 19-9，CA19-9)、糖链抗原72-4(carbohydrate antigen 72-4，CA72-4)的表达水平，采用的手术方式。观察肿瘤标志物表达情况与根治性切除的关系。结果:不同性别、年龄、胃癌发生部位胃癌根治性切除率比较差异无统计学意义(n P均>0.05)，TNM分期(tumor node metastasis classification)III期患者根治性切除率[13.3%(8/60)]低于I期[100%(27/27)]和II期[100%(49/49)](χn 2＝58.166、81.208，n P<0.001)，CEA(＋)患者根治性切除率[47.8%(44/92)]低于CEA(-)患者[90.9%(40/44)](χn 2＝23.394，n P<0.001)，CA19-9(＋)患者根治性切除率[47.7%(42/88)]低于CA19-9(-)患者[87.5%(42/48)](χn 2＝20.804，n P<0.001)，CA72-4(＋)患者根治性切除率[54.3%(51/94)]低于CA72-4(-)患者[78.6%(33/42)](χn 2＝7.268，n P＝0.007)；将单因素分析中n P<0.1的变量纳入Logistic回归模型，包括TNM分期、CEA、CA19-9、CA72-4共4个变量，结果显示，TNM分期(n OR＝1.169，95%n CI＝0.925～1.634，n P＝0.001)、CEA(n OR＝1.067，95%n CI＝1.364～4.338，n P＝0.024)、CA19-9(n OR＝3.012，95%n CI＝1.679～6.317，n P＝0.007)、CA72-4(n OR＝5.364，95%n CI＝0.675～3.224，n P＝0.004)是根治性切除的独立危险因素；肿瘤标志物阳性表达数目与根治性切除率呈负相关(n r＝-0.621，n P<0.05)；能行根治性切除的患者组的CEA、CA19-9、CA72-4表达水平分别75.36(3.76，198.20)μg/L 、152.76(34.81，241.09)kU/L、126.60(4.01，218.07) kU/L，不能行根治性切除的患者组的CEA、CA19-9、CA72-4表达水平分别173.65(120.78，254.87) μg/L、255.88(102.45，395.11) kU/L、201.71(79.15，325.92) kU/L，能行根治性切除的患者组的CEA、CA19-9、CA72-4表达水平均低于不能行根治性切除的患者组，差异有统计学意义(n Z值分别为10.672、8.945、9.862，n P均0.05). TNM classification (tumor node metastasis classification) stage III patients had a lower radical resection rate (63.3%(38/60)) than stage I (100%(27/27)) and II (100%(49/49)) (χn 2=58.166 and 81.208, n P<0.001). The radical resection rate of CEA(+ ) patients (47.8%(44/92)) was lower than that of CEA(-) patients (90.9%(40/44))(χn 2=23.394, n P<0.001). The radical resection rate of CA19-9(+ ) patients (47.7%(42/88)) was lower than that of CA19-9(-) patients(87.5%(42/48))(χn 2=20.804, n P<0.001). The radical resection rate of CA72-4(+ ) patients (54.3%(51/94)) was lower than that of CA72-4(-) patients (78.6%(33/42)) (χn 2=7.268, n P=0.007). The variables with n P<0.1 in univariate analysis were included in the logistic regression model, including 4 variables including TNM stage, CEA, CA19-9, and CA72-4.The results showed that TNM staging (n OR=1.169, 95%n CI=0.925-1.634, n P=0.001), CEA (n OR=1.067, 95%n CI=1.364-4.338, n P=0.024), CA19-9(n OR=3.012, 95%n CI=1.679-6.317, n P=0.007), and CA72-4 were independent risk factors for radical resection(n OR=5.364, 95%n CI=0.675-3.224, n P=0.004). The number of positive expressions of tumor markers was negatively correlated with the radical resection rate (n r=-0.621, n P<0.05). The expression levels of CEA, CA19-9, and CA72-4 in patients with radical resection were 75.36(3.76, 198.20)μg/L, 152.76(34.81, 241.09)kU/L, 126.60(4.01, 218.07)kU/L, respectively.The expression levels of CEA, CA19-9, and CA72-4 in the radically resected patient group were 173.65(120.78, 254.87) μg/L, 255.88(102.45, 395.11) kU/L, 201.71(79.15, 325.92)kU/L.The expression level of CEA, CA19-9, CA72-4 in the group with radical resection were lower than that in the group with no radical resection, and the difference was statistically significant (the Z values were 10.672, 8.945, 9.862, alln P<0.001). ROC curve showed that AUC of CEA, CA19-9 and CA72-4 were 0.627, 0.714 and 0.768, respectively.The best cut-off value of CA72-4 was 87.62 kU/L, the sensitivity was 88.1% (74/84) and the specificity was 90.4% (47/52).n Conclusion:The expression levels and number of tumor markers CEA, CA19-9, CA72-4 in patients with gastric cancer were correlated with the risk of radical resection.