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Objective:The aim of this study was to investigate the value of the combined expression of the gastric mucosal differentiation protein pepsinogen C (PGC) and gastric cancer (GC)-associated antigen MG7 for the diagnosis of GC and prediction of the development from precancerous conditions to GC.Methods:The gastric mucosal biopsies of 285 subjects enrolled from a region with a high incidence of GC were obtained and histopathologically examined.Subjects testing negative for GC (n=208) were followed up from 1998 to 2015.The levels of PGC and MG7 in the biopsies were determined by immunohistochemistry.Results:PGC was positive in 91.4％ of the non-atrophic gastritis,26.5％ of the atrophic gastritis,and 0％ of the GC.MG7 was positive in 15.0％ of the non-atrophic gastritis,82.4％ of the atrophic gastritis,and 94.8％ of the GC.The non-atrophic gastritis group was predominantly PGC+MG7-.The atrophic gastritis and GC groups were predominantly PGC-MG7+.The rate of GC in subjects with PGC-MG7+ staining was 113.4-fold higher [95％ confidence interval (95％ CI):15.3-869.4,P＜0.001] than that in subjects with other staining patts.The sensitivity and specificity of the PGC-MG7+ patt were 92.2 ％ and 78.8％ for the detection of GC and 77.2％ and 97.9％ for GC and precancerous disease,respectively.In the follow-up cohort of non-GC subjects,the risk of developing GC was higher in those with the PGC-MG7+ staining patt.Conclusions:Our data suggest that the PGC-MG7+ patt can be employed as a useful follow-up panel for detecting individuals with a high risk of GC,and the dynamic assessment of the follow-up panel needs multi-centre large-scale validation in the future.