Suzuki, N.; Price, A.; Talbot, I.; Wakasa, K.; Ishiguro, S.; Saunders, B.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA96
Academic Journal
Background: The use of different nomenclature and differences in histological interpretation between Western and Japanese pathologists have caused considerable problems in the diagnosis, treatment and outcome for gastrointestinal epithelial neoplasms. In order to resolve this discrepancy, the Vienna classification (VC) has been developed. Aim: To clarify the discrepancy between UK and Japanese pathologists and to assess the efficacy of the VC for the diagnosis of colorectal neoplasms. Methods: 350 colorectal neoplasms (340 polypectomy and 10 biopsy specimens) were examined by two British (UK1, UK2) and two Japanese (J1, J2) pathologists using both conventional (mildly, moderately, or severely dysplastic adenomas and cancer) and the VC. Result: Under conventional classification, there was moderate to good agreement (κ = 0.63, 0.56) between the pathologists within each country compared to only fair to moderate agreement (κ = 0.29-0.52) between UK and Japanese pathologists. By adopting the VC a better mutual agreement was established between the UK and Japanese pathologists (κ = 0.50-0.64). Japanese pathologists tended to assign a higher grade of dysplasia in both classifications (see Table). Conclusions: The discrepancy caused by different nomenclatures with their possible knock-on differences for clinical management was improved by using the VC. The reason for the higher grading made by Japanese pathologists needs analysis but might be related to more reliance on cytological parameters.


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