Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: Proposal for a new classification system of gastrointestinal epithelial neoplasia

Schlemper, Ronald J.; Kato, Yukio; Stolte, Manfred

doi:10.1046/j.1440-1746.2000.02266.x

Cited by 116 publications

(101 citation statements)

References 28 publications

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“…Considerable discrepancies have been reported between diagnoses of colorectal epithelial neoplastic lesions made by Western and Japanese pathologists from endoscopic cold biopsies and resected specimens of the same lesions [1,2] . Japanese pathologists have distinguished five groups of lesions within the spectrum of colorectal epithelial neoplasia for cold biopsy specimens [Japanese Group Classification (JGC)], namely: normal or benign changes (inflammation/hyperplasia) without atypia [Group 1 (G1)]; non-neoplastic lesions with atypia resulting from inflammation, hyperplasia or regeneration [Group 2 (G2)]; neoplastic lesions with low-grade atypia, including adenomas with mild or moderate atypia and lesions difficult to diagnose as neoplastic or non-neoplastic [Group 3 (G3)]; neoplastic lesions strongly suspected of carcinoma, including adenomas with severe atypia [Group 4 (G4)]; and definite carcinoma [Group 5 (G5)], irrespective of intramucosal or submucosal invasion [3,4] .…”

Section: Introductionmentioning

confidence: 99%

“…To overcome the differences between the conventional Western criteria and the JGC, the Vienna Classification attempted to combine the basic concepts of the conventional Western criteria, which emphasizes that invasion is an indicator of metastatic potential, with the strong points of the JGC, which values consistency between diagnoses of cold biopsy and resected specimens [2,9] . In the revised Vienna Classification (rVC), histopathologic diagnoses are classified into five categories according to neoplastic severity and depth of invasion.…”

Section: Introductionmentioning

confidence: 99%

“…In the revised Vienna Classification (rVC), histopathologic diagnoses are classified into five categories according to neoplastic severity and depth of invasion. This classification also distinguishes between epithelial neoplastic lesions limited to the mucosa and those invading the submucosa [2] . To examine the efficacy of the rVC for diagnosing colorectal polyps ≥ 10 mm, and colorectal lesions suspected of being carcinomas invasive to the submucosa or beyond, including strictures, we prospectively compared the diagnoses from cold biopsy specimens using the rVC guidelines with the diagnoses from resected specimens of the same lesions using the World Health Organization (WHO) classification [10] .…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias

Tominaga¹,

Fujinuma²,

Endo³

et al. 2009

WJG

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AIM:To prospectively investigate the efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplastic lesions in cold biopsy specimens. METHODS:Patients were selected for inclusion if they had colorectal epithelial lesions that were not considered suitable for direct endoscopic resection. These included colorectal polyps ≥ 10 mm and lesions suspected of being carcinomas capable of invading the colorectal submucosa or beyond, including strictures, based on the cold biopsies obtained from each lesion prior to resection. We investigated the relationship between diagnoses based on cold biopsy samples using the revised Vienna Classification and resected specimens of the same lesions, and the therapeutic implications of diagnoses made using the revised Vienna Classification. The same cold biopsy specimens were also examined using the Japanese Group Classification guidelines, and compared with the resected specimens of the same lesions for reference. RESULTS:A total of 179 lesions were identified. The sensitivity, specificity, positive and negative predictive values of the revised Vienna Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 22.2%, 100%, 100%, and 71.4%, r e s p e c t i v e l y, a n d f o r d i s t i n g u i s h i n g b e t w e e n intramucosal lesions and those invading the submucosa or beyond was 59.7%, 100%, 100%, and 37.6%, respectively. The sensitivity, specificity, positive and negative predictive values of the Japanese Group Classification for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 83.3%, 91.4%, 83.3%, and 91.4%, respectively, and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 95.1%, 91.4%, 97.9%, and 82.1%, respectively. A total of 137 of 144 carcinomas that had invaded the submucosa or beyond and three high-grade intraepithelial neoplasias were diagnosed as "carcinoma" using the Japanese Group Classification system. CONCLUSION:The revised Vienna Classification for cold biopsy specimens has high positive predictive value in the diagnosis of colorectal carcinoma invasive to the submucosa or beyond.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias

Tominaga¹,

Fujinuma²,

Endo³

et al. 2009

WJG

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“…A number of previous studies have suggested that low-grade dysplasia (LGD) progresses to HGD [34][35][36][37], and that HGD becomes invasive GC within several months [38][39][40][41][42][43]. In 20-40 % of cases, diagnostic discrepancy between dysplasia evident at biopsy and GC observed in the resection specimen has been reported [34,37,44]. In most cases, the lesions were thought to be cancer at the time of initial biopsy [1,[44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

“…In 20-40 % of cases, diagnostic discrepancy between dysplasia evident at biopsy and GC observed in the resection specimen has been reported [34,37,44]. In most cases, the lesions were thought to be cancer at the time of initial biopsy [1,[44][45][46][47]. From a Western point of view, the final diagnosis rests on examination of the surgical or ESD specimen, because there is some possibility of cancer even if the diagnosis is LGD or HGD [21,23,36,[46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of Western and Japanese criteria for biopsy-based diagnosis of gastric epithelial neoplasia

et al. 2014

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Background In Western countries, gastric cancer (GC) is diagnosed when there is histological evidence of invasion into the lamina propria or beyond the submucosa. In Japan and some other countries, however, diagnosis of GC is based on the degree of structural and cytological abnormality of tumor glands. The aim of the present study was to compare the accuracy of the Western and Japanese criteria for diagnosis of GC. Methods The study included 233 consecutive patients with a postoperative diagnosis of submucosal invasive GC who underwent gastrectomy or endoscopic submucosal dissection. All pretreatment biopsy specimens were independently reviewed by two experts in gastrointestinal pathology employing both the Western and Japanese diagnostic criteria. Diagnostic agreement between pretreatment biopsy specimens and the corresponding resected specimens was evaluated, together with the interobserver agreement for each of the criteria. Results On the basis of the Western and Japanese criteria, the pretreatment biopsy diagnosis was noncancerous (including dysplasia) in 44 lesions and 1 lesion, respectively. Diagnostic accuracy based on biopsy was 81.1 % for the Western criteria and 99.5 % for the Japanese criteria (P \ 0.001). Interobserver agreement based on the Western and Japanese criteria was 73.8 % and 96.5 %, respectively (P \ 0.001). Invasion into the submucosa was detected by biopsy in only 25 cases. Conclusions The Japanese criteria are significantly more accurate for pretreatment biopsy diagnosis of GC. The Western criteria could lead to underdiagnosis of a lesion as high-grade dysplasia, even if submucosal invasive cancer is present.

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Faecal occult blood test-based screening programme with high compliance for colonoscopy has a strong clinical impact on colorectal cancer

Parente

Marino

Devecchi³

et al. 2009

British Journal of Surgery

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Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: Proposal for a new classification system of gastrointestinal epithelial neoplasia

Cited by 116 publications

References 28 publications

Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias

Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias

Comparative study of Western and Japanese criteria for biopsy-based diagnosis of gastric epithelial neoplasia

Faecal occult blood test-based screening programme with high compliance for colonoscopy has a strong clinical impact on colorectal cancer

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