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Copyright ©The Author(s) 2022.
World J Gastroenterol. Dec 28, 2022; 28(48): 6900-6908
Published online Dec 28, 2022. doi: 10.3748/wjg.v28.i48.6900
Table 1 The classifications of gastric adenoma of the Japanese Gastric Cancer Association and gastric superficial lesions of the WHO classification and the Vienna classification
Classification
Code
Diagnosis
Subtype
Subtype 2
JGCA[16]Gastric adenomaIntestinal type
Gastric typePyloric gland type
Foveolar type
WHO 2019[13]8148/0Glandular intraepithelial neoplasia, low grade
8148/2Glandular intraepithelial neoplasia, high grade
8213/0Serrated dysplasia, low grade
8213/2Serrated dysplasia, high gradeIntestinal-type dysplasia
Foveolar-type (gastric type) dysplasia
Gastric pit/crypt dysplasia
8144/0Intestinal-type adenoma, low grade
8114/2Intestinal-type adenoma, low gradeSporadic intestinal-type gastric adenoma
Syndromic intestinal-type gastric adenoma
8210/0Adenomatous polyp, low-grade dysplasia
8210/2Adenomatous polyp, high-grade dysplasia
Vienna[14]3Non-invasive low-grade neoplasiaLow-grade adenoma/dysplasia
4Non-invasive high-grade neoplasia
4.1High-grade adenoma/dysplasia
4.2Non-invasive carcinoma (carcinoma in situ)
4.3Suspicion of invasive carcinoma
5Invasive neoplasia
5.1Intramucosal carcinoma
5.2Submucosal carcinoma or beyond
Revised Vienna[15]3Mucosal low-grade neoplasiaLow-grade adenoma/dysplasia
4Mucosal high-grade neoplasia
4.1High-grade adenoma/dysplasia
4.2Non-invasive carcinoma (carcinoma in situ)
4.3Suspicious for invasive carcinoma
4.4Intramucosal carcinoma
5Submucosal invasion by carcinoma
Table 2 Brief summary of The Cancer Genome Atlas classification
Type
Chromosomal instability
EBV
Microsatellite instability
Genomically stable
Percentage50%9%21%20%
Profile of patientsMale prevalenceElderly ageYounger age
LocationGEJ, cardiaCorpus or fundusAntrumDistal location
Lauren typeIntestinalIntestinalPoorly cohesive
Other pathological featureDNA aneuploidyCarcinoma with lymphoid stroma
PrognosisFavorableWorst
Genetic featuresTP53 mutationExtensive DNA promoter methylationMLH1 promoter hypermethylationLow copy number alterations and mutational burden
Amplification of TKRCDKN2A promoter hypermethylationHigh mutational burdenARID1, RHOA, CDH1 mutations
PIK3CA, ARID1A, BCOR mutationsCLDN18-ARHGAP26 fusion in 15%