Abstract: ObjectiveTo investigate the expression of E-cadherin /TCF4 with combined detection in chronic superficial gastritis, atrophic gastritis and gastric carcinoma and its Lauren's systematic significance. Methods Totally 300 mucosal specimens of chronic superficial gastritis, atrophic gastritis and gastric carcinoma were selected, immunohistochemical double staining were used to observe the expression of E-cadherin/TCF4. Results There were no significant difference among the expression of E-cadherin/TCF4 in chronic superficial gastritis, atrophic gastritis and gastric cancer tissues (P>0.05), so were that between intestinal metaplasia and non-intestinal metaplasia. The expression of E-cadherin-/TCF4- and E-cadherin-/TCF4+ in intestinal type gastric cancer were all lower than that in diffuse type (P<0.01); and the expression of E-cadherin + / TCF4 + (90.0%) in intestinal type were more significant than that in diffuse type (55.0%) (P <0.01). Conclusion Synergistic expression of E-cadherin/TCF4 had statistical significance in different histological classifications of gastric cancer. It can be used as an indicator to determine the histological type of gastric cancer and a new way or direction of the gastric cancer study.