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Increasing PgII serum levels are associated with the whole spectrum of gastric inflammatory diseases, including gastritis induced by <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>). This review critically addresses the clinical value of PgII serology for assessing gastric mucosal inflammation, and as a marker of <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> status, in both <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>\u2010positive patients and after eradication therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A search in PubMed\/Scopus records yielded 39 out of 1190 published scientific studies meeting the selection criteria for this study. In the studies considered, PgII levels were significantly associated with non\u2010atrophic gastric inflammatory lesions (<jats:italic>p<\/jats:italic>\u2010values: 0.025\u20130.0001). <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>\u2010positive patients had significantly higher PgII levels than <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>\u2010negative individuals (<jats:italic>p<\/jats:italic>\u2010values: 0.o5\u20130.0001). While a significant drop in serum PgII levels is consistently reported in <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>\u2010eradicated patients (<jats:italic>p<\/jats:italic>\u2010values: from 0.05 to 0.0001), inconsistencies in the related negative and positive predictive values significantly lower the clinical reliability of PgII testing by comparison with other available non\u2010invasive tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PgII serology may provide clinically useful information on gastric inflammatory diseases, particularly if they are non\u2010atrophic. PgII serology is inconsistent, however, for the purposes of distinguishing patients whose <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> eradication therapy is successful from those who remain infected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12872","type":"journal-article","created":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T19:28:01Z","timestamp":1641670081000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Pepsinogen II in gastritis and <i>Helicobacter pylori<\/i> infection"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8189-7336","authenticated-orcid":false,"given":"Francesco","family":"Di Mario","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University of Parma  Parma 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