{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:42:47Z","timestamp":1776062567217,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background\/aims<\/jats:title>\n                    <jats:p>\n                      Diagnosing active\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) infection in patients with chronic atrophic gastritis (CAG) remains challenging. The monoclonal stool antigen test (SAT) offers a non-invasive alternative to endoscopic methods. This study aimed to evaluate the diagnostic accuracy of SAT in CAG and to analyze its performance in relation to the severity of gastric atrophy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, 287 patients with CAG underwent SAT, urea breath test, serology, and histology. Patients were stratified into low-risk and high-risk groups based on gastric cancer progression risk. SAT was assessed against a reference standard combining histology and UBT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The area under the ROC curve for SAT was 0.858. SAT showed a sensitivity of 75.9% and a specificity of 96.1%. In high-risk patients, SAT demonstrated comparable specificity (96.77% vs. 95.77%) and positive predictive value (95.24% vs. 93.48%) to those in low-risk patients, with numerically higher accuracy (89.29% vs. 86.05%). Consistency analysis revealed substantial agreement between SAT and the reference standard overall (\u03ba=0.72), with stronger agreement in the high-risk patients (\u03ba=0.77) than in the low-risk patients (\u03ba=0.69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Monoclonal SAT is a reliable non-invasive tool for detecting\n                      <jats:italic>H. pylori<\/jats:italic>\n                      in CAG, exhibiting high specificity and strong diagnostic consistency. Its performance is positively correlated with the severity of gastric atrophy, supporting its preferential use in high-risk, advanced atrophy populations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1811628","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:44:10Z","timestamp":1776059050000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Monoclonal stool antigen test for diagnosing Helicobacter pylori in chronic atrophic gastritis: a prospective primary care study"],"prefix":"10.3389","volume":"16","author":[{"given":"Cheng","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingjiacheng","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songzhao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Medical Administration, Hangzhou Women \u2018s Hospital","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuehua","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2853","DOI":"10.1111\/cas.16282","article-title":"The role of gastric mucins and mucin-related glycans in gastric cancers","volume":"115","author":"Arai","year":"2024","journal-title":"Cancer Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1016\/s0140-6736(05)75420-9","article-title":"Diagnosis of Helicobacter pylori infection by HpSA test","volume":"354","author":"Archimandritis","year":"1999","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s10620-015-3877-4","article-title":"Helicobacter pylori infection: Diagnostic strategies in primary diagnosis and after therapy","volume":"61","author":"Atkinson","year":"2016","journal-title":"Dig. 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