Diagnosis of gastric epithelial neoplasia:Dilemma for Korean pathologists
Diagnosis of gastric epithelial neoplasia:Dilemma for Korean pathologists作者机构：Department of PathologyInha University Hospital Department of PathologyYonsei University Wonju College of Medicine Wonju Christian Hospital Department of PathologySungkyunkwan University School of MedicineKangbuk Samsung Medical Center Department of PathologyChungnam National University College of Medicine Department of PathologySungkyunkwan University School of MedicineSamsung Medical Center Department of PathologySeoul National University College of Medicine Department of PathologySoonchunhyang University Hospital Department of PathologyKosin University College of Medicine Department of PathologyUniversity of Ulsan College of MedicineAsan Medical Center Department of PathologyThe Catholic University of KoreaSeoul St.Mary's Hospital Department of PathologySeoul National University Boramae Hospital Department of PathologyEulji General Hospital Department of PathologyInje University Ilsan Paik Hospital Department of PathologyKyunghee University College of Medicine Department of PathologyPusan National University College of Medicine Department of PathologyInje University Seoul Paik Hospital Department of PathologyKorea Cancer Center Hospital Department of PathologyKonkuk University Medical Center Department of PathologyAjou University School of Medicine Department of PathologyChonbuk National University Medical School Department of PathologyKorea University College of Medicine Department of PathologyBundang Jesaeng Hospital Department of PathologyNational Cancer Center The Korean Society of Pathologists4FThe Korean Medical Association BuildingSeoul 140-721South Korea
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2011年第17卷第21期
页 面：2602-2610页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金：Supported by Korean Society of Pathologists
主 题：病理诊断 粘膜上皮 理学家 胃粘膜 韩国 学术交流活动 发育不良 细胞学
摘 要：The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important,but the diagnostic criteria,terminology,and grading system are not the same in the East and West.A structurally invasive focus is necessary to diagnose carcinoma for most Western pathologists,but Japanese pathologists make a diagnosis of cancer based on severe dysplastic cytologic atypia irrespective of the presence of invasion.Although the Vienna classification was introduced to reduce diagnostic discrepancies,it has been difficult to adopt due to different concepts for gastric epithelial neoplastic lesions.Korean pathologists experience much difficulty making a diagnosis because we are influenced by Japanese pathologists as well as Western medicine.Japan is geographically close to Korea,and academic exchanges are active.Additionally,Korean doctors are familiar with Western style medical terminology.As a result,the terminology,definitions,and diagnostic criteria for gastric intraepithelial neoplasia are very heterogeneous in Korea.To solve this problem,the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has made an effort and has suggested guidelines for differential diagnosis:(1) a diagnosis of carcinoma is based on invasion;(2) the most important characteristic of low grade dysplasia is the architectural pattern such as regular distribution of crypts without severe branching,budding,or marked glandular crowding;(3) if nuclear pseudostratification occupies more than the basal half of the cryptal cells in three or more adjacent crypts,the lesion is considered high grade dysplasia;(4) if severe cytologic atypia is present,careful inspection for invasive foci is necessary,because the risk for invasion is very high;and(5) other structural or nuclear atypia should be evaluated to make a final decision such as cribriform pattern,papillae,ridges,vesicular nuclei,high nuclear/cytoplasmic ratio,loss of nuclear polarity,thick and irregular nuclear membrane,and nucleoli.
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