OBJECTIVE: To compare the expression levels of eukaryotic translation initiation factor 4E (eIF4E) and c-Myc proteins in clinically collected samples of noncancerous gastric mucosa, precancerous gastric conditions, and gastric cancer (GA). STUDY DESIGN: A total of 202 samples of gastric mucosal biopsies and surgical resection specimens diagnosed with GA were collected from March 2016 to December 2017 in Wuhan Puren Hospital. These included 23 cases of chronic non-atrophic gastritis, 30 cases of chronic atrophic gastritis, 25 cases of low-grade intraepithelial neoplasia, 27 cases of high-grade intraepithelial neoplasia, and 97 cases of GA. All adjacent tissues of 2–3 cm away from the edge of the GA lesions were also sampled accordingly to serve as noncancerous tissue controls. The expressions of eIF4E and c-Myc in the specimens were examined using immunohistochemistry. RESULTS: In samples of chronic non-atrophic gastritis, the expression level of eIF4E or c-Myc was low. In samples of premalignant conditions and GA, the rates of cells with positive eIF4E and c-Myc expressions were significantly elevated (p<0.01). GA samples had the highest expression levels of eIF4E and c-Myc (p< 0.01). As for paracancerous samples, the expression level of eIF4E protein in those premalignant tissues was higher than that in non-cancerous counterparts (p<0.05 or p<0.01). Importantly, both c-Myc and eIF4E were expressed simultaneously in either precancerous groups or cancer mucosal tissues, showing a significant correlation. CONCLUSION: The expression of eIF4E protein in premalignant conditions may act as an early indicator of GA and a biomarker for its diagnosis. It probably suggests that the elevated expression of eIF4E in the initial stage could lead to the activation of downstream onco enes like c-M c This result rovides us some clues for the GA diagnosis and therapy in the future. © Science Printers and Publishers, Inc.