International Consensus Classification of Gastrointestinal Epithelial Neoplasia: Usefulness for Esophageal Squamous Epithelium
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 . 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 . 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].
KeywordsEndoscopic Mucosal Resection Lymphatic Vessel Invasion Vienna Classification Esophageal Neoplasia Invasive Neoplasia
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