Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists

Schlemper, Ronald J.; Itabashi, Michio; Kato, Yukio; Lewin, Klaus J.; Riddell, Robert H.; Shimoda, Tadakazu; Sipponen, P; Stolte, Manfred; Watanabe, Hidenobu; Takahashi, Hiroshi; Fujita, Rikiya

doi:10.1016/s0140-6736(96)12249-2

Cited by 346 publications

(259 citation statements)

References 17 publications

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“…The situation was different in Japan: temporal trends in incidence by stage showed that the proportion of early tumors almost doubled between 1976-1980 and 1991-1995, whereas it did not vary in Slovenia or in the USA [11]. This difference could be partly explained by differences between pathologist point of view, as Japanese pathologists include among cancers certain lesions, for example, intramucosal carcinomas, that are classified as severe dysplasia in the Western world [12], and by the decreasing proportion over time of unstaged tumors. The increase in Japan could also partly be explained by the development of screening programs in this country [11].…”

Section: Discussionmentioning

confidence: 98%

Trends in the management of gastric cancer over a 32-year period: a French population-based study

et al. 2014

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Background Gastric cancer is still generating interest because of its poor prognosis. The aim of this study was to investigate time trends in diagnostic assessment, patterns of care, and survival of gastric cancers. Methods We considered 5,010 gastric cancers diagnosed between 1976 and 2007 in a well-defined French population. Logistic regressions were used to identify factors associated with R0 resection and operative mortality. A multivariate relative survival analysis was performed. Results Diagnostic modalities have changed. Since 1988, endoscopy is performed when gastric cancer is suspected (95.5 %). However, there has been no strong variation in stage over time: the proportion of stage I cancers increased from 5.5 % to 13.4 % between the periods 1976-1979 and 2004-2007 (p \ 0.001) whereas that of advanced cases remained stable, 64.8 % and 65.0 %, respectively. R0 resections rose from 36.7 % (1976-1979) to 46.7 % between 1980 and 1999, and decreased to 32.7 % thereafter. Age, tumor location, and period were associated with R0 resection. Neoadjuvant and adjuvant chemotherapy were rarely used before 2000, then reached 15.0 % and 19.1 %, respectively, during the later period. Operative mortality after R0 resection decreased from 18.3 % during the 1976-1979 period to 4.3 % during the 2004-2007 period (p \ 0.001). Prognosis slightly improved during the three first periods, from 13.0 % to 22.6 %, then leveled off, not exceeding 26.0 % thereafter. Stage, age, histology, and time period significantly influenced survival. Conclusion Changes in diagnostic modalities were associated with minor changes in stage and prognosis for gastric cancer. Earlier diagnosis and new therapeutic strategies are the best way to improve the prognosis.

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Section: Discussionmentioning

confidence: 98%

Trends in the management of gastric cancer over a 32-year period: a French population-based study

et al. 2014

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“…The histological criteria used to make the histological diagnosis of intramucosal cancer were based on Japanese histological criteria, 11 which differ from those accepted by Western pathologists who consider invasion into the lamina propria of the mucosa mandatory for the diagnosis of carcinoma, whereas the preferred criteria among Japanese pathologists are nuclear and structural abnormalities (atypia). 12 Well-differentiated and moderately differentiated tubular adenocarcinomas and papillary adenocarcinomas corresponding to the intestinal-type (Lauren's classification 1 ) were used to analyze genetic alterations (defined as differentiated-type adenocarcinomas). However, poorly differentiated adenocarcinomas and signet ring cell carcinomas that were classified as diffuse type according to Laurens's classification 1 were excluded from the study.…”

Section: Patient Samplesmentioning

confidence: 99%

Three independent genetic profiles based on mucin expression in early differentiated-type gastric cancers—a new concept of genetic carcinogenesis of early differentiated-type adenocarcinomas

et al. 2004

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Recent molecular studies have shown that the genetic profiles of differentiated-type adenocarcinomas of the stomach are associated with distinct cellular mucin phenotypes (gastric-intestinal-and mixed-phenotypes). Therefore, we examined whether these cellular mucin phenotypes reflect specific molecular genetic alterations, and whether the phenotypes can be used to help categorize the intramucosal neoplasias of gastric tumors. We subclassified tumors into four cellular phenotypes using immunohistochemical mucin analysis. In all, 62 early gastric carcinomas (gastric-phenotype, 13; intestinal-phenotype, 17; mixed-phenotype, 31; unclassifiedphenotype, 1) were examined using a combination of polymerase chain reaction microsatellite assays and immunohistochemical analysis in order to detect chromosomal allelic losses of multiple cancer-related chromosomal loci (1p, 3p, 4p, 5q, 8p, 9p, 13p, 17p, 18q and 22q), microsatellite instability (MSI), and overexpression of the p53 protein. In addition, we analyzed the relationship between MSI status and hMLH1 promoter hypermethylation, which is thought to be a cause of high MSI status. For gastric phenotype cancers, the frequency of 3p allelic loss was higher than that of other microsatellite markers, whereas 5q allelic loss was frequently found in intestinal phenotype cancers. The genetic profile of mixed phenotype cancers is comprised of two distinct genetic types: LOH and MSI types. In the former, 5q, 3p and 18q allelic losses are seen frequently in intramucosal carcinomas. On the other hand, 17p, 1p and 9p allelic losses are associated with the development of submucosal carcinomas. MSI was observed only in mixed phenotype cancers (six of 31 mixed phenotype cancers). Overexpression of the p53 protein is common in differentiated-type gastric cancers. In addition, the MSI status of the tumor cells was correlated with the extent of hypermethylation of the hMLH1 promoter. We suggest that the cellular mucin phenotypes of the differentiated-type adenocarcinomas result from distinct genetic alterations.

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“…In Japan, however, intramucosal tumors are classified together with localized cancers, even in the absence of invasion of the lamina propria. 21 This divergence produces a large discrepancy in prognosis (survival) and is reflected in the ratio of incident cases to cancer deaths. The recent Vienna consensus classification of digestive tumors may reduce this bias in the future.…”

Section: Stages Of Stomach Cancermentioning

confidence: 99%

“…However, even in Japan, the proportion of the population examined in this organized program is not so large; in 1983 the coverage of the screening was 9.6% of the target On the other hand, the decline in the proportion of localized cancer in Slovenia during the period is largely attributable to the progression in staging procedures and the higher resectability rate in the country since 1982. 43 Among the cases detected in Japan at the stage of intramucosal neoplasia, many would be classified high-grade dysplasia in the Western world 21 and not recorded as "cancer." This is a major cause of the different prognosis of stomach cancer in Japan and in the West.…”

Section: Respective Roles Of Lifestyle and Screeningmentioning

confidence: 99%

Incidence and mortality from stomach cancer in Japan, Slovenia and the USA

Lambert

Guilloux

Oshima

et al. 2001

Intl Journal of Cancer

104

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The mortality and incidence from stomach cancer were compared in Japan (a country with a high incidence where there was full application of mass screening during this period) and 2 countries with no screening policy: the USA (with a very low incidence) and Slovenia (with an intermediate rate). The registered cases of stomach cancer were from the Osaka Cancer Registry, the Slovenian National Cancer Registry and the Surveillance, Epidemiology, and End Results (SEER) registries in the USA. In the period 1975-95, the age-adjusted incidence rate (/100,000) of stomach cancer declined in the 3 countries, as follows: Japan, from 76.0 to 53.0 in men and 38.4 to 21.3 in women; Slovenia, from 40.2 to 24.1 in men and 16.6 to 10.8 in women; and the USA, from 9.5 to 6.9 in men and 4.3 to 2.9 in women. During the same period, the age-adjusted mortality rate declined, as follows: Japan, from 60.2 to 34.2 in men and 30.5 to 14.1 in women; Slovenia, from 37.7 to 21.2 in men and 13.8 to 9.0 in women; the USA, from 5.6 to 4.7 in men and 2.5 to 2.3 in women. In the period studied, specific trends on incidence and mortality with a cohort effect occurred only in Japan: analysis by the age period-cohort model confirmed that the decline has occurred since the generations born in 1910. The trend therefore corresponds to unplanned prevention through changes in environmental factors occurring since the early 20 th century. The study of stage-specific incidence rates confirmed the declining trend for regional cancer, whereas there was an increase in the incidence of localized cancer, associated with a period effect in 1975-95. This is attributed to the policy of early detection of stomach cancer, with the inclusion of intramucosal lesions of favorable prognosis and explains why mortality decreased faster than incidence during the period.

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Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists

Cited by 346 publications

References 17 publications

Trends in the management of gastric cancer over a 32-year period: a French population-based study

Trends in the management of gastric cancer over a 32-year period: a French population-based study

Three independent genetic profiles based on mucin expression in early differentiated-type gastric cancers—a new concept of genetic carcinogenesis of early differentiated-type adenocarcinomas

Incidence and mortality from stomach cancer in Japan, Slovenia and the USA

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