Objective To observe the impact of serum miRNA-128a and miRNA-128b expression on early diagnosis and prognosis in patients with gastric cancer. Methods One hundred and eighteen patients with gastric cancer diagnosed in Huashan Hospital,Fudan University from Jan.2015 to Jan.2017 were selected as the gastric cancer group.Seventy-five patients with gastric polyps by pathological diagnosis and 45 healthy people were selected as gastric polyps group and healthy control.Quantitative RT-PCR was used to detect the expression levels of serum miRNA-128a and miRNA-128b in each group.The relation among serum miRNA-128a and miRNA-128b levels,clinic pathological parameters in gastric cancer patients and prognosis was observed,and their efficacy of diagnose and predicting death within 2 years was also observed. Results The serum miRNA-128a expression in gastric cancer group was significantly higher than that in gastric polyp group (q=26.388,P<0.01) and healthy control (q=32.195,P<0.01),the expression in gastric polyp group was significantly higher compared with the healthy control (q=7.198,P<0.01),and after operation the expression level was significantly lower than that before operation (t=14.321,P<0.01).The serum miRNA-128b expression in gastric cancer group was significantly lower than that in gastric polyp group (q=211.148,P<0.01) and healthy control group (q=249.984,P<0.01),the expression of those in gastric polyp group was also significantly lower compared healthy control group(q=38.232,P<0.01),and the expression was significantly higher after surgery than before surgery (t=15.139,P<0.01).The serum miRNA-128a and miRNA-128b expression had high sensitivity and specificity in the diagnosis of gastric cancer,the sensitivity of combined detection was 78.8%,the specificity was 97.3%,and the area under curve was significantly higher than miRNA-128a (Z=3.436,P<0.01) and miRNA-128b (Z=2.658,P<0.01).The expression of serum miRNA-128a and miRNA-128b in patients with gastric cancer were significantly correlated with tumor cell differentiation,TNM staging,lymph node metastasis and depth of invasion (P<0.01).After 2 years' follow-up,the serum miRNA-128a expression in survival group was significantly lower than that in death group (P<0.01).When its level was >98.47 fmol/L,the sensitivity of predicting death within 2 years was 89.5%,the specificity was 81.8%,and the curve area was 0.889.The serum miRNA-128b expression in survival group was significantly higher than that in death group (P<0.01),when its level was ≤ 94.86 fmol/L,the sensitivity of predicting death within 2 years was 94.7%,the specificity was 81.8%,and the curve area was 0.931. Conclusions Combined detection of serum miRNA-128a and miRNA-128b is helpful for diagnosis in patients with gastric cancer and has important reference value for predicting death in gastric cancer patients within 2 years. [ABSTRACT FROM AUTHOR]