International Consensus Classification of Gastrointestinal Epithelial Neoplasia: Usefulness for Esophageal Squamous Epithelium

  • Ronald J. Schlemper


In 1998 a review of 21 esophageal squamous biopsy and resection specimens by 31 pathologists from 12 countries showed that definite carcinoma was the diagnosis in fewer than 20% of assessments by the Western pathologists but in more than 80% by the 9 Japanese specialists in gastrointestinal pathology [1]. There was agreement between the Western and Japanese viewpoints for only 14% of the specimens [2,3]. In many cases Western pathologists diagnosed high-grade dysplasia when the Japanese diagnosed carcinoma. Western pathologists considered invasion into the lamina propria of the mucosa mandatory for the diagnosis of carcinoma, whereas nuclear and structural features were more important for the Japanese. Most Western pathologists made a discrepant diagnosis of dysplasia in the biopsy specimen and carcinoma in the resected specimen in some of the cases where they assessed both biopsy and resection specimens from the same esophageal lesion [1]. Similar differences were found between the Western and Japanese pathologists in the diagnosis of adenoma/ dysplasia versus carcinoma in 35 gastric and 20 colorectal glandular lesions [1, 2, 3].


Endoscopic Mucosal Resection Lymphatic Vessel Invasion Vienna Classification Esophageal Neoplasia Invasive Neoplasia 
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  1. 1.
    Schlemper RJ, Kato Y, Stolte M (2000) Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: proposal for a new classification system of gastrointestinal epithelial neoplasia. J Gastroenterol Hepatol 15:G49–G57PubMedCrossRefGoogle Scholar
  2. 2.
    Schlemper RJ, Riddell RH, Kato Y, et al (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255PubMedCrossRefGoogle Scholar
  3. 3.
    Schlemper RJ, Kato Y, Riddell RH, et al (1999) New international consensus classification of gastrointestinal epithelial neoplasia (Vienna classification). Stomach Intestine 34:1043–1049Google Scholar
  4. 4.
    Schlemper RJ, Dawsey SM, Itabashi M, et al (2000) Differences in diagnostic criteria for esophageal squamous cell carcinoma between Japanese and Western pathologists. Cancer 88:996–1006PubMedCrossRefGoogle Scholar
  5. 5.
    Momma K, Yoshida M, Nakamura J, et al (1997) Endoscopic mucosal resection for mucosal cancer of the esophagus. Clin Gastroenterol 12:1733–1740Google Scholar
  6. 6.
    Makuuchi H (1996) Endoscopic mucosal resection for early esophageal cancer: indications and techniques. Dig Endosc 8:175–179Google Scholar
  7. 7.
    Takeshita K, Tani M, Inoue H, et al (1997) Endoscopic treatment of early oesophageal or gastric cancer. Gut 40:123–127PubMedGoogle Scholar
  8. 8.
    Makuuchi H, Shimoda H, Mizutani K, et al (1997) Endoscopic criteria for invasive depth of superficial esophageal cancer. Dig Endosc 9:110–115CrossRefGoogle Scholar
  9. 9.
    Schlemper RJ, Itabashi M, Kato Y, et al (1997) Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists. Lancet 349:17251729CrossRefGoogle Scholar
  10. 10.
    Schlemper RJ, Borchard F, Dixon MF, et al (2000) International comparability of the pathological diagnosis for early cancer of the digestive tract: Munich meeting. J Gastroenterol 35(suppl XII): 102–110PubMedGoogle Scholar
  11. 11.
    Tajima Y, Nakanishi Y, Ochiai A, et al (2000) Histopathologic findings predicting lymph node metastasis and prognosis of patients with superficial esophageal carcinoma: analysis of 240 surgically resected tumors. Cancer 88:1285–1293PubMedCrossRefGoogle Scholar
  12. 12.
    Watanabe H, Komukai S, Ajioka Y, et al (1998) Histopathology of m3 and sml invasive squamous cell carcinoma of the esophagus with special reference to endoscopic resection. Stomach Intestine 33:985–992Google Scholar
  13. 13.
    Isono K, Sato H, Nakayama K (1991) Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology 48:411–420PubMedCrossRefGoogle Scholar
  14. 14.
    Makuuchi H, Shimada H, Chino O, et al (1998) Possibility of endoscopic mucosal resection in patients with m3 and sml esophageal cancer. Stomach Intestine 33:993–1002Google Scholar
  15. 15.
    Schlemper RJ, Kato Y, Stolte M (2001) Review of histological classifications of gastrointestinal epithelial neoplasia: differences in diagnosis of early carcinomas between Japanese and Western pathologists. J Gastroenterol 36:445–456PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2002

Authors and Affiliations

  • Ronald J. Schlemper
    • 1
  1. 1.Department of Internal MedicineFukuoka University School of MedicineFukuokaJapan

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