The Vienna classification of gastrointestinal epithelial neoplasia
Ronald J. Schlemper,Robert H. Riddell,Yo Kato,F Borchard,Harry S. Cooper,Sanford M. Dawsey,Michael F. Dixon,C M Fenoglio-Preiser,Jean-François Fléjou,Karel Geboes,Takanori Hattori,T Hirota,Masayuki Itabashi,Mitsuya Iwafuchi,Akinori Iwashita,Y I Kim,Thomas Kirchner,M Klimpfinger,Morio Koike,Gregory Y. Lauwers,Klaus J. Lewin,Georg Oberhuber,Felix Offner,A B Price,Carlos A. Rubio,M Shimizu,Tadakazu Shimoda,Pentti Sipponen,Enrico Solcia,M Stolte,Hiroshi Watanabe,Hirohiko Yamabe +31 more
TLDR
The differences between Western and Japanese pathologists in the diagnostic classification of gastrointestinal epithelial neoplastic lesions can be resolved largely by adopting the proposed terminology, which is based on cytological and architectural severity and invasion status.Abstract:
Background—Use of the conventional Western and Japanese classification systems of gastrointestinal epithelial neoplasia results in large diVerences among pathologists in the diagnosis of oesophageal, gastric, and colorectal neoplastic lesions. Aim—To develop common worldwide terminology for gastrointestinal epithelial neoplasia. Methods—Thirty one pathologists from 12 countries reviewed 35 gastric, 20 colorectal, and 21 oesophageal biopsy and resection specimens. The extent of diagnostic agreement between those with Western and Japanese viewpoints was assessed by kappa statistics. The pathologists met in Vienna to discuss the results and to develop a new consensus terminology. Results—The large diVerences between the conventional Western and Japanese diagnoses were confirmed (percentage of specimens for which there was agreement and kappa values: 37% and 0.16 for gastric; 45% and 0.27 for colorectal; and 14% and 0.01 for oesophageal lesions). There was much better agreement among pathologists (71% and 0.55 for gastric; 65% and 0.47 for colorectal; and 62% and 0.31 for oesophageal lesions) when the original assessments of the specimens were regrouped into the categories of the proposed Vienna classification of gastrointestinal epithelial neoplasia: (1) negative for neoplasia/dysplasia, (2) indefinite for neoplasia/dysplasia, (3) non-invasive low grade neoplasia (low grade adenoma/ dysplasia), (4) non-invasive high grade neoplasia (high grade adenoma/ dysplasia, non-invasive carcinoma and suspicion of invasive carcinoma), and (5) invasive neoplasia (intramucosal carcinoma, submucosal carcinoma or beyond). Conclusion—The diVerences between Western and Japanese pathologists in the diagnostic classification of gastrointestinal epithelial neoplastic lesions can be resolved largely by adopting the proposed terminology, which is based on cytological and architectural severity and invasion status. (Gut 2000;47:251‐255)read more
Citations
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Helicobacter pylori infection and the development of gastric cancer
Naomi Uemura,Sumika Okamoto,Susumu Yamamoto,Nobuyuki Matsumura,Shigeki Yamaguchi,Michio Yamakido,Kiyomi Taniyama,Noboyuki Sasaki,Ronald J Schlemper +8 more
TL;DR: Gastric cancer develops in persons infected with H. pylori but not in uninfected persons, and those with histologic findings of severe gastric atrophy, corpus-predominant gastritis, or intestinal metaplasia are at increased risk.
Journal ArticleDOI
Retrospective study: The diagnostic accuracy of conventional forceps biopsy of gastric epithelial compared to endoscopic submucosal dissection (STROBE compliant).
TL;DR: According to the analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found and young women with low-grade intraepithelial neoplasia could select regular follow-up.
The Paris endoscopic classification of superficial neoplastic lesions : esophagus, stomach and colon.
H. Inoue,Hiroshi Kashida,Shin-ei Kudo,M. Sasako,T Shimoda,H Watanabe,Shigeto Yoshida,M. Guelrud,Charles J. Lightdale,Kenneth K. Wang,Robert H. Riddell,Diebold,R Lambert,JF Rey,Michael E. Jung,Horst Neuhaus,A. T. R. Axon,Robert M. Genta,J. J. Gonvers +18 more
TL;DR: An international group of endoscopists, surgeons, and pathologists gathered in Paris for an intensive workshop designed to explore the utility and clinical relevance of the Japanese endoscopic classification of superficial neoplastic lesions of the GI tract.
Journal ArticleDOI
British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus
Rebecca C. Fitzgerald,Massimiliano di Pietro,Krish Ragunath,Yeng Ang,Jin-Yong Kang,Peter H. Watson,Nigel Trudgill,Praful Patel,Philip Kaye,Scott Sanders,M O'Donovan,Elizabeth L. Bird-Lieberman,Pradeep Bhandari,Janusz Jankowski,Stephen Attwood,Simon L. Parsons,Duncan Loft,Jesper Lagergren,Paul Moayyedi,Georgios Lyratzopoulos,John de Caestecker +20 more
TL;DR: These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia and suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria for the first time.
Journal ArticleDOI
Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial.
Kazutoshi Fukase,Mototsugu Kato,Shogo Kikuchi,Kazuhiko Inoue,Naomi Uemura,Shiro Okamoto,Shuichi Terao,Kenji Amagai,Shunji Hayashi,Masahiro Asaka +9 more
TL;DR: Prophylactic eradication of H pylori after endoscopic resection of early gastric cancer should be used to prevent the development of metachronous gastric carcinoma.
References
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Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists
Ronald J Schlemper,Masayuki Itabashi,Yo Kato,Klaus J. Lewin,Robert H. Riddell,Tadakazu Shimoda,Pentti Sipponen,Manfred Stolte,Hidenobu Watanabe,Hiroshi Takahashi,Rikiya Fujita +10 more
TL;DR: In Japan, gastric carcinoma is diagnosed on nuclear and structural criteria even when invasion is absent according to the Western viewpoint, which may also contribute to the relatively high incidence and good prognosis of gastric cancer in Japan when compared with Western countries.
Journal ArticleDOI
Differences in the diagnostic criteria used by japanese and western pathologists to diagnose colorectal carcinoma
Ronald J. Schlemper,Masayuki Itabashi,Yo Kato,Klaus J. Lewin,Robert H. Riddell,Tadakazu Shimoda,Pentti Sipponen,M Stolte,Hidenobu Watanabe +8 more
TL;DR: It is essential to know whether the criteria for the histologic diagnosis of colorectal carcinoma are similar in Japan and Western countries.
Journal ArticleDOI
Differences in diagnostic criteria for esophageal squamous cell carcinoma between Japanese and Western pathologists.
Ronald J. Schlemper,Sanford M. Dawsey,Masayuki Itabashi,Akinori Iwashita,Yo Kato,Morio Koike,Klaus J. Lewin,Robert H. Riddell,Tadakazu Shimoda,Pentti Sipponen,Manfred Stolte,Hidenobu Watanabe +11 more
TL;DR: Large discrepancies have been found between Western and Japanese pathologists in the diagnosis of adenoma/dysplasia versus carcinoma for gastric and colorectal glandular lesions.