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目的:探讨胃癌(GC)患者血清中长链非编码RNA(lncRNA)H19、lncRNA母系表达基因3(MEG3)的表达及临床意义。方法:选取宿迁市第一人民医院2017年7月至2018年8月收治的87例GC患者为GC组，51例良性肿瘤患者为良性肿瘤组，40名体检健康者为健康对照组，测定各组血清lncRNA H19、lncRNA MEG3表达水平，分析其与GC患者临床病理特征和预后的关系及对GC的诊断价值。结果:健康对照组、良性肿瘤组、GC组血清lncRNA H19水平依次递增，lncRNA MEG3水平依次降低(n P<0.05)；GC组血清lncRNA H19水平与肿瘤浸润深度、TNM分期、淋巴结转移有关，lncRNA MEG3水平与分化程度、TNM分期、淋巴结转移有关(n P<0.05)；随访13～32(23.54±4.18)个月，87例GC患者存活63例，Kaplan-Meier生存曲线显示，高血清lncRNA H19水平组和低血清lncRNA MEG3水平组总生存率明显低于低血清lncRNA H19水平组和高血清lncRNA MEG3水平组(n P<0.05)；多因素Cox回归分析显示，lncRNA H19(n HR＝3.442，95% n CI：0.089～23.421)为GC患者预后独立危险因素，lncRNA MEG3(n HR＝4.386，95% n CI：0.934～20.596)为保护因素(n P<0.05)；受试者工作特征(ROC)曲线显示，血清lncRNA H19＋lncRNA MEG3(AUC＝0.922，95%n CI：0.861～0.962)诊断GC的灵敏度、特异度、准确度均高于血清lncRNA H19(AUC＝0.840，95% n CI：0.771～0.904)、lncRNA MEG3(AUC＝0.830，95% n CI：0.753～0.890)单独诊断。n 结论:GC患者血清lncRNA H19水平明显升高，lncRNA MEG3水平明显降低，与肿瘤发生和发展及预后密切相关，联合检测可提升GC的诊断价值。“,”Objective:To investigate the expression and clinical significance of long non-coding RNA (lncRNA) H19 and lncRNA maternally expressed gene 3 (MEG3) in the serum of patients with gastric cancer (GC).Methods:A total of 87 GC patients admitted to the First People′s Hospital of Suqian (July 2017 to August 2018) were selected as the GC group, 51 patients with benign tumors as the benign tumor group, and 40 healthy people with physical examination as the healthy control group. The expression levels of lncRNA H19 and lncRNA MEG3 in serum were measured; the relationship between the expression levels of the two and clinicopathological features and prognosis of patients with GC was analyzed.Results:The levels of serum lncRNA H19 in healthy control group, benign tumor group and GC group were gradually increased, and lncRNA MEG3 level was gradually decreased (n P<0.05); the serum lncRNA H19 level in GC group was related to tumor invasion depth, tumor node metastasis (TNM) stage and lymph node metastasis. The level of lncRNA MEG3 was related to the degree of differentiation, TNM stage and lymph node metastasis (n P<0.05). Among the 87 GC patients , 63 patients were followed up for 13-32 months with an average of (23.54±4.18)months. Kaplan Meier survival curve showed that the overall survival rate of high serum lncRNA H19 group and low serum lncRNA MEG3 level group was significantly lower than that of low serum lncRNA H19 level group and high serum lncRNA H19 level group. Multivariate Cox regression analysis showed that lncRNA H19 (n HR=3.442, 95% n CI=0.089-23.421) was an independent prognostic factor for GC patients, and lncRNA MEG3 (n HR=4.386, 95% n CI=0.934-20.596) was a protective factor (n P<0.05); receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum lncRNA H19+ lncRNA MEG3 [area under curve (AUC)=0.922, 95%n CI=0.861-0.962] were higher than those of serum lncRNA H19 (AUC=0.840, 95% n CI=0.771-0.904) and lncRNA MEG3 (AUC=0.830, 95% n CI=0.753-0.890).n Conclusions:The level of serum lncRNA H19 in GC patients is significantly increased, and the level of lncRNA MEG3 is significantly reduced, which is closely related to tumor occurrence, development and prognosis. Combined detection of the two can enhance the diagnostic value of GC.