Abstract: Objective To investigate the expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood of patients with gastric cancer and to discuss its clinical significance. Methods hTERT mRNA in peripheral blood was detected by TaqMan real timequantitative reverse transcriptase-polymerase chain reaction（RT-PCR）in 58 patients with gastric cancer and 20 healthy subjects.The patients were followed for 2 years. Results The positive rate of hTERT mRNA in patients with gastric cancer was 55.17%（ 32 / 58），which was significantly higher than that in the healthy controls（P＜0.001）.Univariate analysis revealed that depth of tumor invasion（P=0.038），tumor lymphatic metastasis（P=0.008）,distant metastasis （P＜0.001）and clinical stages （P=0.003）were related to the hTERT mRNA expression in peripheral blood of the gastric cancer patients，among them lymphatic metastasis and distant metastasis were independent compact factors of the hTERT mRNA expression in peripheral blood of gastric cancer patients. The positive rate of hTERT mRNA in patients with chemotherapy no-response was significantly higher than those in the patients with chemotherapy response.The rate of one year survival for patiens with positive hTERT mRNA before chemotherapy was lower than those with negative one (P＜0.001). Conclusion hTERT mRNA can be used as a marker for the detection of tumor micrometastasis in gastric cancer，and it may be important to regularly detection for evaluating chemotherapy response and prognosis.Lymphatic metastasis and distant metastasis were closely correlated with the expression of hTERT mRNA in peripheral blood of patients with gastric cancer