Objective To investigate the serum CEA,CA199,CA242,CA724,AFP levels as tumor markers for diagnosis and prognosis of gastric cancer.Methods The serum concentrations of CEA,CA199,CA724,AFP were detected in 108 patients with gastric cancer by ECLIA (electrochemiluminescence immunoassay) method.CA242 by ELISA method.The survival analysis was performed by the Kaplan-Meier method,Cox' s proportional hazards model was used for multivariate analysis of prognosis.Results Using healthy subjects group as control,the ROC-AUC of CEA,CA199,CA242,CA724 were 0.735,0.714,0.598,0.576.The sensitivity,specificity and Youden index were 40.2 ％,97.7 ％,0.379; 43.0 ％,91.3 ％,0.343;35.2 ％,94.8 ％,0.300 and 31.3 ％,95.3 ％,0.266,respectively.For combined detection of CEA,CA199,CA242,CA724,the sensitivity,specificity and Youden Index were 76.8 ％,82.3 ％,0.585.The levels of CEA,CA724 were closely related to lymph node status (both P ＜ 0.05).The concentrations of CEA,CA199,CA242 were significantly related to vascular embolization,distant metastases and ascites (all P ＜ 0.05).The patients of lump and catheter had significantly higher of AFP compared with patients of invasion and anabrosis (P ＜ 0.05).In gastric cancer patients,the size of the primary tumors was closely related to the preoperative serum levels of CEA,AFP,CA724 (P ＜ 0.05).During follow-up,there were 34 cases of death in 59 patients,and the median survival time were 18.1,10.9 months for the patients with CEA negative and positive (P ＜ 0.005).Conclusions Combing detection of CEA,CA199,CA242,CA72 can improve sensitivity of gastric cancer,and play an important role in forecasting the recurrence,metastasis,curing and prognosis evaluation.CEA is an important predictor of recurrence and prognosis of gastric cancer.