Objective： To discuss the relationship between the microcosmic-differentiation syndrome types of gastric mucosa of patients with chronic atrophic gastritis(CAG)and precancerous lesions.Methods：Made microcosmic syndrome differentiation and typing，histopathological and immunohistochemical examination for the gastric mucosa of 220 cases of CAG patients，compared the difference between incidence of precancerous lesions and immunohistochemical indexes(CD34+，Ki67)of patients with different microcosmic syndrome types，and discussed the relationship between microcosmic syndrome differentiation of gastric mucosa of CAG patients and precancerous lesions. Results：Among the 220 cases of the microcosmic-differentiation syndrome types of gastric mucosa tissue of CAG patients，there were 72 cases of stomach-yin deficiency type，36 cases of spleen-stomach deficiency cold type，34 cases of liver depression and qi stagnation type，31 casesof blood-stasisin stomach collateralstype， 28 casesof liver-stomach heat stagnation type， 19 casesof spleen-stomach dampnessand heat type.Compared the Hp infection positive rate of CAG patientswith different microcosmic-differentiation syndrome types，there was no significance being found(P＞0.05).The rate of intestinal metaplasia of liver depression and qi stagnation typeand spleen-stomach dampnessand heat typewashigher than that of spleen-stomach deficiency cold type and stomach-yin deficiency type，differences being significant(P ＜ 0.05)；the rate of intraepithelial neoplasia of liver depression and qi stagnation type was higher than that of spleen-stomach deficiency cold type and stomach-yin deficiency type，differences being significant(P＜0.05).The average CD34+optical density of liver depression and qi stagnation type was higher than that of liver-stomach heat stagnation type，blood-stasis in stomach collaterals type，spleen-stomach deficiency cold type and stomach-yin deficiency type(P ＜ 0.05)；the average CD34+optical density of liver-stomach heat stagnation type and spleen-stomach deficiency cold type was higher than that of blood-stasis in stomach collaterals type and stomach-yin deficiency type(P＜0.05).The average Ki67 optical density of liver depression and qi stagnation type and spleen-stomach dampness and heat type was higher than that of spleen-stomach deficiency cold type，stomach-yin deficiency type and blood-stasis in stomach collaterals type(P＜ 0.01，P＜0.05)，and the average Ki67 optical density of spleen-stomach dampness and heat type was higher than that of liver-stomach heat stagnation type(P＜0.01，P＜0.05).ConclusionMicrocosmic syndrome differentiation of gastric mucosa of CAG patients is closely related to precancerous lesions，and incidence of precancerous lesions of patients of type and type is higher，to which effective intervention should be given to decrease incidence of gastric cancer.