[目的]在血清中寻找早期胃癌及癌前病变相关的标志物,初步探讨其临床意义。[方法]收集浙江省肿瘤医院经病理证实的血清标本279例,其中早期胃癌100例,胃上皮内瘤变38例,萎缩性胃炎41例及正常对照100例。采用弱阳离子交换纳米磁珠(WCX)和表面增强激光解吸电离飞行时间质谱(SELDI-TOF-MS)技术检测获得血清多肽谱,用CiphergenProteinChip3.2.1和Biomarker Wizard软件进行分析,筛选差异峰后,采用SPSS13.0软件ROC曲线进一步评价其敏感度和特异性。[结果]与正常人群比较,早期胃癌组质荷比(m/z)为2745、3400的蛋白峰低表达,诊断敏感度分别为67.92%、66.83%,特异性分别为90.89%、81.02%;胃上皮内瘤变组m/z为2745的蛋白峰低表达,诊断敏感度和特异性分别是77.79%、82.27%;萎缩性胃炎组m/z为4800的蛋白峰低表达,诊断敏感度和特异性分别是58.52%、89.68%。[结论]m/z为2745、3400、4800的差异峰具有诊断早期胃癌及癌前病变的潜力。 [Objective] To find the early gastric cancer and precancerous lesions in serum, and to explore its clinical significance. [Methods] 279 cases of pathologically confirmed serum samples collected from Zhejiang Cancer Hospital were collected, including 100 cases of early gastric cancer, 38 cases of intraepithelial neoplasia, 41 cases of atrophic gastritis and 100 cases of normal control. Serum peptides were detected by WCX and SELDI-TOF-MS, and analyzed by Ciphergen Protein 3.3.1 and Biomarker Wizard software. After screening the difference peaks, SPSS13.0 software ROC curve to further evaluate the sensitivity and specificity. [Results] Compared with the normal population, the peak value of m / z was 2745 and 3400 in early gastric cancer group, respectively. The diagnostic sensitivity was 67.92% and 66.83% respectively, and the specificity was 90.89% and 81.02% respectively. In the intraepithelial neoplasia group, the peak value of m / z was 2745, the diagnostic sensitivity and specificity were 77.79% and 82.27%, respectively. The protein peak of m / z 4800 in atrophic gastritis group was low, and the diagnostic sensitivity and The specificity was 58.52% and 89.68% respectively. [Conclusion] The differential peak with m / z of 2745, 3400 and 4800 has the potential of diagnosing early gastric cancer and precancerous lesions.