Objective: To estimate the practical values of pepsinogen C (PGC) dynamic expression and the levels of serum pepsinogens in gastric cancer screening and diagnosis. Methods: 129 cases gastric mucosa biopsies and serum specimens were examined. The expression of PGC in stomach mucosa was detected by immunohistochemistry. The serum concentration of pepsinogen A (sPGA) and pepsinogen C (sPGC) were determined by ELISA. Results: The positive rate of PGC antigen expression decreased in superficial gastritis (100%), gastric ulcer or erosion (80.00%), atrophic gastritis (34.48%) and gastric cancer (11.43%) in sequence (P<0.05). There was no statistics difference in concentration of sPGA and sPGC among the above 4 groups. The ratio of sPGA/sPGC decreased in superficial gastritis, gastric ulcer or erosion, atrophic gastritis and gastric cancer in sequence (P<0.05). There was specific correlation between the expression of PGC in stomach mucosa and the levels of sPGA/sPGC ratio in serum (rs =0.297, P=0.001). Conclusion: Tissue expression of PGC has close relationship with different gastric diseases. The ratio of sPGA/sPGC is relative with the tissue expression of PGC antigen and may be a convenient and economic maker in screening and diagnosis of gastric cancer.