PT - JOURNAL ARTICLE AU - R J Schlemper AU - R H Riddell AU - Y Kato AU - F Borchard AU - H S Cooper AU - S M Dawsey AU - M F Dixon AU - C M Fenoglio-Preiser AU - J-F Fléjou AU - K Geboes AU - T Hattori AU - T Hirota AU - M Itabashi AU - M Iwafuchi AU - A Iwashita AU - Y I Kim AU - T Kirchner AU - M Klimpfinger AU - M Koike AU - G Y Lauwers AU - K J Lewin AU - G Oberhuber AU - F Offner AU - A B Price AU - C A Rubio AU - M Shimizu AU - T Shimoda AU - P Sipponen AU - E Solcia AU - M Stolte AU - H Watanabe AU - H Yamabe TI - The Vienna classification of gastrointestinal epithelial neoplasia AID - 10.1136/gut.47.2.251 DP - 2000 Aug 01 TA - Gut PG - 251--255 VI - 47 IP - 2 4099 - http://gut.bmj.com/content/47/2/251.short 4100 - http://gut.bmj.com/content/47/2/251.full SO - Gut2000 Aug 01; 47 AB - BACKGROUND Use of the conventional Western and Japanese classification systems of gastrointestinal epithelial neoplasia results in large differences among pathologists in the diagnosis of oesophageal, gastric, and colorectal neoplastic lesions.AIM To develop common worldwide terminology for gastrointestinal epithelial neoplasia.METHODS Thirty one pathologists from 12 countries reviewed 35 gastric, 20 colorectal, and 21 oesophageal biopsy and resection specimens. The extent of diagnostic agreement between those with Western and Japanese viewpoints was assessed by kappa statistics. The pathologists met in Vienna to discuss the results and to develop a new consensus terminology.RESULTS The large differences between the conventional Western and Japanese diagnoses were confirmed (percentage of specimens for which there was agreement and kappa values: 37% and 0.16 for gastric; 45% and 0.27 for colorectal; and 14% and 0.01 for oesophageal lesions). There was much better agreement among pathologists (71% and 0.55 for gastric; 65% and 0.47 for colorectal; and 62% and 0.31 for oesophageal lesions) when the original assessments of the specimens were regrouped into the categories of the proposed Vienna classification of gastrointestinal epithelial neoplasia: (1) negative for neoplasia/dysplasia, (2) indefinite for neoplasia/dysplasia, (3) non-invasive low grade neoplasia (low grade adenoma/dysplasia), (4) non-invasive high grade neoplasia (high grade adenoma/dysplasia, non-invasive carcinoma and suspicion of invasive carcinoma), and (5) invasive neoplasia (intramucosal carcinoma, submucosal carcinoma or beyond).CONCLUSION The differences between Western and Japanese pathologists in the diagnostic classification of gastrointestinal epithelial neoplastic lesions can be resolved largely by adopting the proposed terminology, which is based on cytological and architectural severity and invasion status.