Grading System for Gastric Epithelial Proliferative Diseases Standardized Guidelines proposed by Korean Study Group for Pathology of Digestive Diseases

Kim, Hoguen; Jin, So Young; Jang, Ja June; Kim, Woo Ho; Song, Sang Yong; Kim, Kyu Rae; Yu, Eun Sil; Shin, Hyung Sik; Kim, Han Kyeom; Sohn, Jin Hee; Hong, Eun Kyung; Kim, Youn Wha; Jeong, Jin Sook; Kim, Chang Jin; Choi, Shin Eun; Park, In Suh; Park, Chan Il; Kim, Yong Il

Abstract

The assessment of epithelial changes in gastric mucosal biopsies has been one of the major problems caused by inconsistencies in and disagreements about nomenclature and interpretation. To resolve these issues, members of the Study Group for Pathology of Digestive Diseases reviewed microslides of 50 gastric lesions showing varying degrees of mucosal abnormality and reached the following consensus; 1) the proliferating gastric epithelium can be divided into hyperplastic and neoplastic; 2) the term "dysplasia" is reserved for the microscopic epithelial changes that are unequivocally neoplastic; 3) Biopsy specimens can be categorized as regenerative(negative for dysplasia), indefinite(questionable dysplasia), positive(positive for dysplasia) and overt carcinoma; 4) The positive category can be divided into two subgroups, high grade dysplasia and low grade dysplasia. Criteria for each grade are presented and discussed. We offer these guidelines for establishing the correct diagnosis of the gastric mucosal biopsy specimens and for prospective studies.