Objective To explore the clinical significance of serum pepsinogen (PG) Ⅰ, Ⅱand their ratio combined with Helicobacter pylori (Hp) antibody in the diagnosis of early gastric cancer in the elderly.Methods From August 2018 to July 2019, 56 elderly patients with early gastric cancer and gastritis treated in our hospital were selected as subjects.They were evenly divided into the gastric cancer group and gastritis group, 28 cases in each group.Twentyeight healthy subjects for physical examinations were selected as the healthy physical examination group during the same period.The levels of PG Ⅰand PG Ⅱ, Hp antibody expression level were compared between the three groups.Results Check the display, the levels of PG Ⅰand PG Ⅱin the gastric cancer group were lower than those in the healthy physical examination group and gastritis group;the levels of PG Ⅰand PG Ⅱin the gastritis group were lower than those of the healthy physical examination group, the differences were statistically significant (P<0.05).There were no significant differences in the ratio of PG Ⅰto PG Ⅱbetween the three groups (P>0.05).The positive rate of Hp antibody in the gastric cancer group were higher than those in the gastritis group and the healthy physical examination group, the positive rate of Hp antibody in the gastritis group was higher than that of the healthy physical examination group, and the differences were statistically significant (P<0.05).Conclusion Serum pepsinogen Ⅰ, Ⅱand their ratios combined with Hp antibody obtain remarkable effects in the diagnosis of early gastric cancer in the elderly, and can be used to diagnose early gastric cancer in the elderly, and have high clinical application value.