| Gastric cancer is one of the most common malignant carcinoma, however, until now the definite pathogenesis has not been fully understood. As the leading cause of mortality among malignant carcinoma, GC not only threats people's health, but also brings numerous economic expenses. Studies show using reasonable examining methods can not only reduce unwanted wastes but also improve the diagnosis and, as a result, can improve the prognosis. At present, there are many examining methods to GC, consisting of imaging analysis and many other experimental examinations. It is urgent to choose some examining methods, which both are available and can reduce expenses to the large extent. We have set up the database of all suspected GC patients admitted in Xijing hospital from January, 1982 to December, 2000.In order to evaluate these diagnostic criteria subjectively, we chose 284 cases of suspected GC enrolled from January, 1982 to December, 2000 were reviewed at Xijing hospital, aging from 25 to 74, the average age is 52.4. Fibro-gastroscopy, B-mode Ultrasound Examination and X-ray Barium Meal Examination were used in all 284 cases, while 162 cases proved to have GC detected and analyzed serum tumor markers (CEA, CAL9-9 and CA72-4) and Hp IgG antibody. Surgical operation and/or pathology was used as a gold standard, together with clinical epidemiological index, to evaluate the diagnostic value of these methods, aiming to have a comprehensive, objective and scientific evaluation to these methods. Random sampling and blind measurement were used in the study. The sensitivity, specificity and accuracy of fibro-gastroscopY were 96.97%, 98.68% and 97.8 1%, respectively; of B-mode Ultrasound Examination were 95.45%, 93.42% and 94.36% respectively; of X-ray barium meal examination were 87.12%, 78.94%, and 82.75% respectively. By odd product test, results suggested that the accuracy of fibro-gastroscopy and B-mode Ultrasound Examination were not statistically significant (u1.l0,p>0.l). But the accuracy of fibro-gastroscopy, as well as B-mode Ultrasound Examination was better than that of X-ray barium meal examination(u=4 .87 ,u3 .96,p<0 .0005) .Results show that fibro-gastroscopy is high sensitivity and specification, meanwhile, it can conduct biopsy. So, it can be the major diagnostic method. B-mode Ultrasound examination has advantages by providing useful information about the definite locus, tumor infiltrate depth and range, as well as periphery lymph nodes metaptosis. And it is no trauma and can be accepted easily and provide supplementary diagnosis. Comparatively, although the accuracy of X-ray barium meal examination is low, its unique is that it can show pathological range and macropathological grouping directly. It can be used to improve diagnostic rate. The sensitivity of serum tumor markers CEA-. CA19-9 and CA72-4 is 24.0% 35.5% and 21.9%;the specificity is 93%-. 77% and 100% respectively; the accuracy value is 48.8% 51.7% and 47.7% respectively. An ideal serum tumor marker can not only foretell tumor existence, locu and form, but also possess high sensitivity and specificity. But serum tumor markers (EA, CA19-9 and CA72-4) detected in our retrospective cases has lower sensitivity, higher specificity in diagnosis of the GC. As a screening method, the low sensitivity of serum tumor markers can not meet this demand. Even using all the antigens at the same time, the sensitivity can only be improved to about 50%. However, because of its high specificity, it will has important clinical value if the results is posi...
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