Combination of Paris and Vienna classifications may optimize follow-up of gastric epithelial neoplasia patients

Med Sci Monit. 2015 Apr 5:21:992-1001. doi: 10.12659/MSM.892697.

Abstract

Background: The aim of this study was to evaluate the efficiency of the combination of Paris and Vienna classifications in a follow-up study of gastric epithelial neoplasia (GEN) patients.

Material and methods: This study was conducted between January 2003 and September 2010, during which 170 biopsy-proven GEN patients were followed up by gastroenterologists and pathologists according to our follow-up regimen (modified Vienna classification).

Results: In total, 161 patients with low-grade neoplasia (LGN) and 9 patients with high-grade neoplasia (HGN) were randomly enrolled in our study. Eighteen patients with depressed appearance were observed, of which 9 patients had HGN and 9 patients had low-grade dysplasia (LGD). Three patients with type 0-IIa were observed with low-grade adenoma (LGA), and type 0-I was observed in 2 patients with LGN. Endoscopic or surgical treatments were performed to avoid potential malignancy or bleeding. Two patients with ulcer lesions, 2 patients with non-depressed type 0 appearance, and 3 patients without visible lesions were shown to have higher-grade lesions during follow-up. The misdiagnosis rate of forceps biopsy - 62.07% - was determined by comparing pre- and post-resection diagnoses of 29 patients.

Conclusions: The combination of the Paris and Vienna classifications for GEN may optimize the follow-up routines for patients with suspicious precancerous lesions and may significantly improve the detection of early gastric cancer (EGC) while helping gastroenterologists select the best therapy option.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Demography
  • Epithelium / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Stomach Neoplasms / classification
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy
  • Treatment Outcome