title: The Japanese Viewpoint on the Histopathology of Early Gastric Cancer.
abstract: Japanese histopathologists have traditionally had greater opportunity to study the histology and clinical course of early gastric cancer because of technological developments including double contrast radiography and endoscopy systems, combined with the higher incidence of gastric cancer in the general population in Japan. Endoscopic resection is now considered best practice for treatment of early gastric cancers with a negligible risk of lymph node metastasis. Histopathologic evaluation plays a critical role in assessing the likelihood of lymph node metastasis on endoscopically resected specimens. There remains disparity between Western and Japanese histopathologists in the conceptual approach to the histopathologic evaluation of neoplastic lesions in the upper gastrointestinal tract, in particular regarding lesions straddling the borderline between noninvasive and invasive disease. Although in routine practice, the clinical impact of these conceptual differences is small, this disparity does complicate international exchange of datasets and the development of globally applicable formal definitions. Here we review the current practice in histological diagnosis of early gastric cancer in Japan and discuss some of the conceptual differences between Japanese and Western histopathological assessment of lesions in the neoplastic stomach.
authors: Pathology Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. ssekine@ncc.go.jp.
authors: Shigeki
authors: S
authors: Sekine
authors: Pathology Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
authors: Hiroshi
authors: H
authors: Yoshida
authors: UCL Cancer Institute, University College London, London, UK.
authors: Marnix
authors: M
authors: Jansen
authors: Department of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical Science, Seta, Otsu, Shiga, 520-2192, Japan.
authors: Ryoji
authors: R
authors: Kushima
mesh_terms: D055088:Early Detection of Cancer; D005753:Gastric Mucosa / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D010338:Pathology, Clinical / Q000379:methods*; D017410:Practice Guidelines as Topic; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*
keywords: EBV; Endoscopy; Gastric cancer; Helicobacter pylori; Histopathology