Histopathological classification is in a pivotal position in both basic research and clinical diagnosis and treatment of gastric cancer. Currently, there are different classification systems in basic science and clinical application. In medical literatures, different classifications are used including Lauren and WHO systems, which have confused many researchers. Lauren classification has been proposed for half a century, but is still used worldwide. It shows many advantages of simple, easy handling with prognostic significance. The WHO classification scheme is better than Lauren classification in that it is continuously being revised according to the progress of gastric cancer, and is always used in the clinical and pathological diagnosis of common scenarios. Along with the progression of genomics, transcriptomics, proteomics, metabolomics researches, molecular classification of gastric cancer becomes the current hot topics. The traditional therapeutic approach based on phenotypic characteristics of gastric cancer will most likely be replaced with a gene variation mode. The gene-targeted therapy against the same molecular variation seems more reasonable than traditional chemical treatment based on the same morphological change.
Humans ; Molecular Biology ; Stomach Neoplasms ; classification ; pathology

Adenocarcinoma ; classification ; genetics ; pathology ; surgery ; Cardia ; Esophageal Neoplasms ; classification ; genetics ; pathology ; surgery ; Esophagogastric Junction ; pathology ; Humans ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Stomach Neoplasms ; classification ; genetics ; pathology ; surgery

Adenoma ; pathology ; Carcinoma ; pathology ; Carcinoma in Situ ; pathology ; Gastric Mucosa ; pathology ; Humans ; Neoplasm Invasiveness ; Precancerous Conditions ; pathology ; Stomach Neoplasms ; classification ; pathology

Adenoma ; classification ; pathology ; Carcinoma in Situ ; classification ; pathology ; Carcinoma, Squamous Cell ; classification ; pathology ; Colorectal Neoplasms ; classification ; pathology ; Esophageal Neoplasms ; classification ; pathology ; Gastrointestinal Neoplasms ; classification ; pathology ; Humans ; Hyperplasia ; classification ; pathology ; Neoplasm Staging ; Precancerous Conditions ; classification ; pathology ; Stomach Neoplasms ; classification ; pathology ; World Health Organization

BACKGROUND AND METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists developed a standardized pathology reporting format for gastric cancer in collaboration with the Korean Gastric Cancer Association. RESULTS: The diagnostic parameters are divided into two part: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by UICC, the WHO classification, and the Korean Gastric Cancer Association classification. Therefore, the standard part is adequate for routine surgical pathology service. We included detailed descriptions on each item. CONCLUSIONS: The authors anticipate that this standardization can improve the diagnostic accuracy and decrease the discrepancies that occur in the pathologic diagnosis of gastric cancer. Furthermore, the standard format can encourage large scale multi-institutional collaborative studies.
Asian Continental Ancestry Group ; Classification ; Cooperative Behavior ; Diagnosis ; Humans ; Neoplasm Staging ; Pathology* ; Pathology, Surgical ; Stomach Neoplasms*

Adenocarcinoma ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cardia ; Esophageal Neoplasms ; classification ; pathology ; Esophagogastric Junction ; pathology ; Humans ; Neoplasm Staging ; Stomach Neoplasms ; classification ; pathology

Gastric epithelial neoplasia is a very common disease entity in Korea, encompassing gastric adenoma and adenocarcinoma. There are still discrepancies in pathologic diagnosis of gastric epithelial neoplasia between Western and Japanese pathologists after Vienna consensus classification. With increasing use of endoscopic therapy such as endoscopic mucosal resection and endoscopic submucosal dissection, it is very important to agree on the consensus criteria in the diagnosis of gastric epithelial neoplasia among pathologists in Korea. On this background, the current concepts, and contemporary issues of definition, diagnostic and classification criteria of gastric epithelial neoplasia were reviewed.
Adenocarcinoma/classification/*pathology ; Adenoma/classification/*pathology ; Biopsy ; Consensus Development Conferences as Topic ; Endoscopy, Gastrointestinal ; Epithelial Cells/pathology ; Humans ; Japan ; Observer Variation ; Stomach Neoplasms/classification/*pathology ; *Terminology as Topic

OBJECTIVETo investigate the clinicopathological characteristics between mucinous gastric cancer (MGC) and poorly differentiated gastric cancer(PDGC) and factors associated with prognosis.

METHODSMedical records of 1016 consecutive patients with gastric cancer were retrospectively reviewed. Sixty-eight patients with MGC and 508 with PDGC were identified. Clinicopathologic characteristics and overall survival data were analyzed.

RESULTSAs compared to PDGC patients, patients with MGC were significantly older [(59.2±11.9) years vs. (54.1±13.2) years], had significantly more distant metastasis(36.8% vs. 23.8%), more peritoneal seeding(29.4% vs. 16.9%), and less radical resection(60.3% vs. 76.6%). There were no significant differences in 5-year survival rate between MGC and PDGC patients(29.4% vs. 35.5%). However, for tumors in the middle third of the stomach, the survival rate of MGC patients was lower than that of PDGC. Using a Cox proportional hazard ratio model, lymph node involvement and radical resection were independent prognostic factors for survival of MGC patients, while tumor invasion, lymph node involvement, and radical resection were associated with survival in patients with PDGC.

CONCLUSIONAlthough MGC and PDGC differ in age, frequencies of peritoneal seeding, distant metastasis, and rate of radical resection, overall survival is comparable.

Aged ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; classification ; pathology

OBJECTIVEEndoscopy was used to study the high incidence area of cancer of gastric cardia.

METHODS417 patients with early cardiac cancer and 451 patients with advanced lesions were analyzed to the high incidence point of cardiac cancer. Verifying endoscopic screening of 205 subjects was performed later in the high incidence area of esophageal cancer.

RESULTS327 of 417 (78.4%) of early cardiac cancer patients and 336 of 451 (74.5%) of advanced lesions were proved to have developed their origin at the root of the mucosal fold in the gastric cardia. Eleven cardiac cancer patients were found by the verifying endoscopic screening, among whom 9 patients (81.8%) developed the primary focus at the root of mucosal fold in the cardia.

CONCLUSIONThe root of mucosal fold in the gastric cardia is proved to be the high incidence point of cancer of gastric cardia, which is very important clinically.

China ; epidemiology ; Gastroscopy ; methods ; Humans ; Incidence ; Stomach Neoplasms ; classification ; diagnosis ; epidemiology ; pathology

TNM staging is essential for clinical decision-making and prognostic prediction for patients with gastric cancer. The 7th TNM staging manual was formulated in 2009 and implemented in 2010. However, it was published that there were some deficiencies of the 7th edition of gastric cancer TNM staging system in clinical application process, and this old staging system could not meet the clinical needs. With the cooperation and promotion of the American Joint Committee on Cancer (AJCC), the International Union for Cancer Control (UICC) and the International Gastric Cancer Association (IGCA), and through the accumulation and analysis of gastric cancer big data, the 8th TNM staging system was published at the end of 2016. The updated staging system has defined the selection of staging system for esophagogastric junction cancer. It also has divided N3 into N3a and N3b, which has been incorporated into the new staging system, leading to more accurate risk stratification. Moreover, the cTNM staging system and ypTNM staging system have been added in the new staging manual. Overall, the 8th TNM staging system can facilitate more reasonable decision-making, more accurate prognostic prediction and better evaluation of therapeutic strategy. It is of high value to promote diagnostic and therapeutic standard for gastric cancer.
Clinical Decision-Making ; Esophagogastric Junction ; pathology ; Humans ; Neoplasm Staging ; standards ; Prognosis ; Stomach Neoplasms ; classification