Serum Markers

  • Masanori ItoEmail author
  • Tomoyuki Boda
  • Takahiro Kotachi
  • Mariko Kiso
  • Kazuhiko Masuda
  • Kosaku Hata
  • Masaharu Yoshihara
  • Shinji Tanaka
  • Kazuaki Chayama


The evaluation of Helicobacter pylori infection or the presence of chronic gastritis induced by H. pylori is regarded as the most important risk factor for gastric cancer development. The serum antibody test against H. pylori is the most popular in the clinical practice as well as for a population-based gastric cancer mass survey. However, some H. pylori-infected patients had negative titer (called negative-high titer), which may be induced by unexpected or accidental eradication of H. pylori. Serum pepsinogen (PG) is another popular serum marker for evaluating the status of gastric inflammation. Miki first established a systematic diagnostic panel with PG-I and PG I/II levels to evaluate gastric cancer risk, which was called the “pepsinogen test.” Further, Miki and Inoue created a diagnostic panel by combination of serum anti-H. pylori antibody titer and the PG test, which is called the “ABC risk stratification system.” However, in this system, contamination of patients with past infection of H. pylori into Group A is a crucial problem called the “pseudo A problem.” Recently, the Japanese Society for Helicobacter Research have created a new flow chart for diagnosis and treatment by considering gastric cancer risk by H. pylori infection. In this panel, morphological (endoscopic) evaluation is included to diagnose H. pylori-uninfected patients with serum antibody test.


Helicobacter pylori Serum antibody Pepsinogen Pepsinogen test ABC risk stratification system Endoscopy 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Masanori Ito
    • 1
    Email author
  • Tomoyuki Boda
    • 2
  • Takahiro Kotachi
    • 1
  • Mariko Kiso
    • 1
  • Kazuhiko Masuda
    • 1
  • Kosaku Hata
    • 1
  • Masaharu Yoshihara
    • 3
  • Shinji Tanaka
    • 2
  • Kazuaki Chayama
    • 1
  1. 1.Department of Gastroenterology and MetabolismHiroshima UniversityHiroshimaJapan
  2. 2.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  3. 3.Health Service CenterHiroshima UniversityHigashi-HiroshimaJapan

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