Rugge M, Correa P, Dixon M F, Hattori T, Leandro G, Lewin K, Riddell R H, Sipponen P, Watanabe H
Department of Surgical and Oncological Sciences, Università degli Studi di Padova, Italy.
Am J Surg Pathol. 2000 Feb;24(2):167-76. doi: 10.1097/00000478-200002000-00001.
A worldwide-accepted histologic, classification of the gastric carcinomatous and precancerous lesions is a prerequisite for a consistent recording of epidemiologic data and for both developing and evaluating primary and secondary preventive efforts. Different nomenclatures have been proposed for gastric precancerous lesions in eastern countries and in Japan. This article presents a classification of gastric precancerous lesions resulting from an international consensus conference involving pathologists of different countries. Five main diagnostic categories are identified. To allow comparisons with the nomenclature proposed by the Japanese Research Society for Gastric Cancer, each category was also assigned a numeric identification: 1 = normal, 2 = indefinite for dysplasia, 3 = noninvasive neoplasia, 4 = suspicious for invasive cancer, and 5 = cancer. The interobserver reproducibility of the histologic classification was tested in a series of 46 cases. By collapsing benign alterations (categories 1+2) versus noninvasive neoplasia (category 3) versus suspicious for invasive cancer and fully appearing carcinomatous lesions (categories 4+5), the general agreement value was 77.7%, whereas kappa coefficient was 0.63. By examining gastric precancerous lesions from diverse populations, the authors agreed that the gastric precancerous process is universal and the differences in nomenclatures are merely semantics. The international Padova classification of the gastric precancerous lesions is submitted to the attention of the international scientific community, which is invited to test and to improve on it.
全球公认的胃癌及癌前病变的组织学分类，是一致记录流行病学数据以及开展和评估一级与二级预防措施的前提条件。在东方国家和日本，针对胃癌前病变提出了不同的命名法。本文介绍了一个由不同国家病理学家参与的国际共识会议所产生的胃癌前病变分类。确定了五个主要诊断类别。为便于与日本胃癌研究学会提出的命名法进行比较，每个类别还被赋予了一个数字标识：1 = 正常，2 = 发育异常不明确，3 = 非侵袭性肿瘤，4 = 疑为浸润癌，5 = 癌。在46例病例系列中测试了组织学分类的观察者间再现性。通过将良性改变（类别1 + 2）与非侵袭性肿瘤（类别3）与疑为浸润癌及完全显现的癌性病变（类别4 + 5）进行对比，总体一致性值为77.7%，而kappa系数为0.63。通过检查不同人群的胃癌前病变，作者们一致认为胃癌前病变过程是普遍存在的，命名上的差异仅仅是语义上的。现将国际帕多瓦胃癌前病变分类提交给国际科学界关注，邀请其进行测试并加以完善。
