Vienna classification of gastrointestinal neoplasia

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The Vienna classification of gastrointestinal neoplasia was compiled in 1998 by the World Congress of Gastroenterology in response to differences in the diagnostic distinction between adenomas / dysplasias on one hand, and carcinoma on the other, between Japan and the Western world. Differences in the diagnostic criteria were found to be a serious problem in the transferability of research results. The results were published in 2000 (Schlemper et al., 2000), in 2002, the classification was slightly modified.

The classification divides neoplasia into five categories, and proposes recommended clinical management for each category:

  1. negative finding: optional follow-up.
  2. indeterminate finding: monitoring.
  3. mucosal low-grade neoplasia: endoscopic resection or follow-up:
    • low-grade adenoma,
    • low-grade dysplasia.
  4. mucosal high-grade neoplasia: endoscopic or local surgical resection:
    • high-grade adenoma/dysplasia,
    • non-invasive carcinoma (carcinoma in situ),
    • suspicion of invasive carcinoma,
    • intramucosal carcinoma.
  5. carcinoma with submucosal invasion: surgical resection.

The choice of therapeutic procedure from category 3 upwards is governed primarily by the size of the lesion, the depth of invasion and the age and comorbidities of the patient. From the histopathological characteristics, the original works recommend taking into account especially the invasion of lymphatic and blood vessels and possibly the depth of invasion under the mucosa.

The WHO classification of the 2000s prefers the term intraepithelial neoplasia over the term dysplasia.

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Literature[edit | edit source]

  • STOLTE, M.. The new Vienna classification of epithelial neoplasia of the gastrointestinal tract: advantages and disadvantages. Virchows Arch.[online]. 2003, vol. 442, no. 2, s. 99-106, available from <https://www.ncbi.nlm.nih.gov/pubmed/12596058</>. ISSN 0945-6317. 
  • SCHLEMPER, R. J., R. H. RIDDELL a Y. KATO, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. [online]. 2000, vol. 47, no. 2, s. 251-5, also available from <https://gut.bmj.com/content/47/2/251.long</>. ISSN 0017-5749.
  • DIXON, M. F.. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut. [online]. 2002, vol. 51, no. 1, s. 130-1, also available from <https://gut.bmj.com/content/51/1/130.long</>. ISSN 0017-5749.
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