Non-invasive Testing in Gastric Diseases

Non-invasive markers for gastric disease are highly useful, ideally allowing to diagnose a disease or a condition in a simple and convenient way. Such markers could also be of importance in population-based screening.

This review provides an overview of non-invasive markers for H.pylori gastritis, autoimmune gastritis, gastric precancerous conditions and lesions, as well as gastric cancer. Traditionally used markers, such as non-invasive tests for H.pylori, pepsinogen and gastrin tests for atrophic gastritis, anti-parietal cell and anti- intrinsic factor antibodies for autoimmune gastritis, as well as newer tests are discussed. Current key guidelines on the routinely used tests are summarized.

A brief insight is provided to the status of volatile breath markers, plasma metabolic fingerprinting, as well as the use of circulating tumor cells, circulating tumor DNA, cell-free RNA, and extracellular vesicles in gastric cancer testing.

There is still a clear unmet need for perfect non-invasive markers in early gastric cancer and precancer lesion detection. Additional research is required to justify the available test application in clinical practice.