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Copyright ©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Jun 7, 2011; 17(21): 2602-2610
Published online Jun 7, 2011. doi: 10.3748/wjg.v17.i21.2602
Table 1 Definitions and grading systems proposed for gastric epithelial neoplasia
ReferencesDysplasia and related lesions (from Rugge et al[40], modified)
Takagi et al[15]Benign
Borderline
Carcinoma
Nagayo[14]Atypical
Borderline
Probable cancer
Definitive cancer
Grundmann[2]Low-grade GED
High-grade GED
Invasive cancer
Oehlert et al[5]Slight GED
Moderate GED
Severer GED
Invasive cancer
Morson et al[4]Regenerative
Mild GED
Moderate GED
Severe GED
Invasive cancer
Ming et al[7]Grade 1 GED
Grade 2 GED
Grade 3 GED
Grade 4 GED
Invasive cancer
Japanese classification of gastric carcinoma[16]Group I lesions
Group II lesions
Group III-IV lesions
Group V lesions
Goldstein et al[9]Reactive
Indefinite for GED
Low-grade GED
High-grade GED
Invasive cancer
Padova classificationNegative
Indefinite for dysplasia
Noninvasive neoplasia
Suspect for invasive carcinoma
Invasive carcinoma
Vienna classificationNegative
Indefinite for dysplasia
Low grade neoplasia
High grade neoplasia
Invasive neoplasia
Table 2 Differentiation of low and high grade dysplasia and gastric carcinomas
HistologyFeatureLow-grade dysplasiaHigh-grade dysplsiaCarcinoma
Structural atypiaGland sizeUniformVariableVariable
Gland arrangementRegularSlightly irregularIrregular
Glandular crowdingSlightModerateMarked
Glandular transition to surrounding mucosaNoNoNo
Glandular branching/buddingFocalProminentProminent
Glandular cribriformNoYesYes
Surface maturationNoNoNo
Nuclear atypiaShapeElongatedElongated and/or irregularOval/round
PseudostratificationBasal 1/2Over basal 1/2Irregular
MembraneThinThickUneven
HyperchromasiaHyperchromatic evenHyperchromatic irregularVesicular
PleomorphismNoMildModerate to marked
Prominent nucleoliAbsentPresentPresent
Loss of polarityNoNo/yesYes
StromaInvasionNoNoYes
Table 3 Inter-observer agreement rate before and after consensus conferences
Agreement rate (%)Before (%)After (%)
0-5016 (38.1)1 (2.4)
51-6013 (31.0)4 (9.5)
61-703 (7.1)8 (19.0)
71-805 (11.9)6 (14.3)
81-903 (7.1)6 (14.3)
91-1002 (4.8)17 (40.5)
Total42 (100)42 (100)