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{{CMG}}{{AE}}{{PSD}}
{{CMG}};{{AE}} {{OK}}, {{PSD}}, {{MAD}}
{{Stomach cancer}}
{{Stomach cancer}}
==Overview==
==Overview==
[[Gastric cancer]] can be classified according to the Padova [[classification]] [[system]] based upon the grade of [[metaplasia]], [[dysplasia]] and invasiveness of the [[disease]]. It may also be classified according to the Japanese classification system based on the type of [[lesions]] ([[benign]] or [[malignant]]) and [[atypia]].


==Classification==
==Classification==
[[Gastric cancer]] can be classified according to the Padova [[classification]] [[system]] based upon the grade of [[metaplasia]], [[dysplasia]] and invasiveness of the [[disease]]. It may also be classified according to the Japanese classification system based on the type of [[lesions]] ([[benign]] or [[malignant]]) and [[atypia]]. The following tables briefly outline the major [[classification]] [[systems]]:<ref name="pmid10680883">{{cite journal| author=Rugge M, Correa P, Dixon MF, Hattori T, Leandro G, Lewin K et al.| title=Gastric dysplasia: the Padova international classification. | journal=Am J Surg Pathol | year= 2000 | volume= 24 | issue= 2 | pages= 167-76 | pmid=10680883 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10680883  }}</ref><ref name="pmid27342689">{{cite journal| author=Japanese Gastric Cancer Association| title=Japanese gastric cancer treatment guidelines 2014 (ver. 4). | journal=Gastric Cancer | year= 2017 | volume= 20 | issue= 1 | pages= 1-19 | pmid=27342689 | doi=10.1007/s10120-016-0622-4 | pmc=5215069 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27342689  }}</ref>


=== World Health Organization histological classification of gastric tumors: ===
=== '''Padova classification''' ===
{| class="wikitable"
{| class="wikitable"
!Types
! colspan="2" |'''1.  Negative for [[dysplasia]]'''
!Histological features
|-
!1.0
|Normal
|-
!1.1
|Reactive foveolar [[hyperplasia]]
|-
!1.2
|Intestinal [[metaplasia]] (IM)
|-
!1.2.1
|IM Complete type
|-
!1.2.2
|IM Incomplete type
|-
! colspan="2" |'''2.  Indefinite for [[dysplasia]]'''
|-
!2.1 
|Foveolar hyperproliferation
|-
!2.2 
|Hyperproliferative IM
|-
| colspan="2" |'''3.  Non-invasive [[neoplasia]] (flat or elevated [synonym adenoma])'''
|-
!3.1 
|Low-grade
|-
!3.2 
|High-grade
|-
!3.2.1 
|Including suspicious for [[carcinoma]] without [[invasion]] (interglandular)
|-
|-
|'''Epithelial tumors'''
!3.2.2 
|
|Including [[carcinoma]] without invasion (intraglandular)
* '''Adenoma'''
* '''Carcinoma'''
* Adenocarcinoma
* Intestinal type
* Diffuse type
* Papillary adenocarcinoma
* Tubular adenocarcinoma
* Mucinous adenocarcinoma
* Signet-ring cell carcinoma
* Adenosquamous carcinoma
* Squamous cell carcinoma
* Small cell carcinoma
* Undifferentiated carcinoma
 
* '''Carcinoid (well differentiated endocrine neoplasm)'''
|-
|-
|'''Non-epithelial tumors'''
! colspan="2" |'''4.  Suspicious for invasive [[carcinoma]]'''
|Leiomyoma
Schwannoma
 
Granular cell tumour
 
Glomus tumour
 
Leiomyosarcoma
 
GI stromal tumour
 
Benign
 
Uncertain malignant potential
 
Malignant
 
Kaposi sarcoma
|-
|-
|'''Malignant lymphomas'''
! colspan="2" |'''5.  Invasive [[adenocarcinoma]]'''
|Marginal zone B-cell lymphoma of MALT-type
Mantle cell lymphoma
 
Diffuse large B-cell lymphoma
|}
|}


=== Japanese histological classification of gastric tumors: ===
=== Japanese classification ===
{| class="wikitable"
{| class="wikitable"
!
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
!
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Definition
|-
!Group I
|Normal [[mucosa]] and [[benign]] [[lesions]] with no [[atypia]]
|-
!Group II
|[[Lesions]] showing [[atypia]] but diagnosed as [[benign]] (non-[[Neoplastic disease|neoplastic]])
|-
|-
|
!Group III
|
|Borderline [[lesions]] between [[benign]] and [[malignant]]
===== Benign epithelial tumor =====
Adenoma
 
===== Malignant epithelial tumor =====
'''Common type'''
 
Papillary adenocarcinoma
 
Tubular adenocarcinoma
 
Well-differentiated
 
Moderately differentiated
 
Poorly differentiated adenocarcinoma
 
Solid type
 
Non-solid type
 
Signet-ring cell carcinoma
 
Mucinous adenocarcinoma 
|-
|-
|Special types
!Group V
|Carcinoid tumor
|[[Lesions]] strongly suspected of [[carcinoma]]
Endocrine carcinoma
 
Carcinoma with lymphoid stroma
 
Hepatoid adenocarcinoma
 
Adenosquamous carcinoma
 
Squamous cell carcinoma
 
Undifferentiated carcinoma
|-
|-
|Miscellaneous carcinoma
!Group V
|Non-epithelial tumor
|[[Carcinoma]]
Gastrointestinal stromal tumor (GIST)
 
Smooth muscle tumor
 
Neurogenic tumor
 
Miscellaneous non-epithelial tumors
 
Lymphoma
 
B-cell lymphoma
 
MALT (mucosa-associated lymphoid tissue) lymphoma
 
Follicular lymphoma
 
Mantle cell lymphoma
 
Diffuse large B-cell lymphoma
 
Other B-cell lymphomas
 
T-cell lymphoma
 
Other lymphomas
 
Metastatic tumor
 
Tumor-like lesion
 
Hyperplastic polyp
 
Fundic gland polyp
 
Heterotopic submucosal gland
 
Heterotopic pancreas
 
Inflammatory fibroid polyp
 
Gastrointestinal polyposis
 
Familial polyposis coli, Peutz–Jeghers syndrome
|}
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Conditions diagnosed by stool test]]
[[Category:Primary care]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 23:04, 4 April 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], Parminder Dhingra, M.D. [3], Mohammed Abdelwahed M.D[4]

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Overview

Gastric cancer can be classified according to the Padova classification system based upon the grade of metaplasia, dysplasia and invasiveness of the disease. It may also be classified according to the Japanese classification system based on the type of lesions (benign or malignant) and atypia.

Classification

Gastric cancer can be classified according to the Padova classification system based upon the grade of metaplasia, dysplasia and invasiveness of the disease. It may also be classified according to the Japanese classification system based on the type of lesions (benign or malignant) and atypia. The following tables briefly outline the major classification systems:[1][2]

Padova classification

1. Negative for dysplasia
1.0 Normal
1.1 Reactive foveolar hyperplasia
1.2 Intestinal metaplasia (IM)
1.2.1 IM Complete type
1.2.2 IM Incomplete type
2. Indefinite for dysplasia
2.1 Foveolar hyperproliferation
2.2 Hyperproliferative IM
3. Non-invasive neoplasia (flat or elevated [synonym adenoma])
3.1 Low-grade
3.2 High-grade
3.2.1 Including suspicious for carcinoma without invasion (interglandular)
3.2.2 Including carcinoma without invasion (intraglandular)
4. Suspicious for invasive carcinoma
5. Invasive adenocarcinoma

Japanese classification

Category Definition
Group I Normal mucosa and benign lesions with no atypia
Group II Lesions showing atypia but diagnosed as benign (non-neoplastic)
Group III Borderline lesions between benign and malignant
Group V Lesions strongly suspected of carcinoma
Group V Carcinoma

References

  1. ↑ Rugge M, Correa P, Dixon MF, Hattori T, Leandro G, Lewin K; et al. (2000). "Gastric dysplasia: the Padova international classification". Am J Surg Pathol. 24 (2): 167–76. PMID 10680883.
  2. ↑ Japanese Gastric Cancer Association (2017). "Japanese gastric cancer treatment guidelines 2014 (ver. 4)". Gastric Cancer. 20 (1): 1–19. doi:10.1007/s10120-016-0622-4. PMC 5215069. PMID 27342689.

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