The team, led by Dr R Schlemper of Fukuoka University in Japan, designed the new classification at a workshop in Vienna in September 1998.
31 Pathologists involved:
R J Schlemper, R H Riddell, Y Kato, F Borchard, H S Cooper, S M Dawsey, M F Dixon, C M Fenoglio-Preiser, J-F Fléjou, K Geboes, T Hattori, T Hirota, M Itabashi, M Iwafuchi, A Iwashita, Y I Kim, T Kirchner, M Klimpfinger, M Koike, G Y Lauwers, K J Lewin, G Oberhuber, F Offner, A B Price, C A Rubio, M Shimizu, T Shimoda, P Sipponen, E Solcia, M Stolte, H Watanabe, H Yamabe.
The Vienna classification was conceived to replace the existing Western and Japanese systems for the classification of tumors, which can result in inconsistent diagnoses of neoplasia amongst Western and Japanese pathologists.
The pathologists were asked to diagnose 35 gastric, 20 colorectal and 21 esophageal biopsy and resection specimens using both the existing and Vienna classification systems.
The Vienna system showed a marked improvement in the consistency of diagnoses.
The percentage of gastric specimens where there was agreement in diagnoses improved from 37% using the conventional classification, to 71% using the Vienna system.
62% of esophageal specimens and 45% of colorectal specimens were diagnosed consistently using the Vienna system compared to only 14% and 45% using the existing classification systems.
"This consensus classification is currently undergoing further evaluation and refinement"
The Vienna classification of gastrointestinal epithelial neoplasia, outlined in the August 2000 issue of Gut, is summarized below:
|Category 1||Negative for neoplasia/dysplasia|
|Category 2||Indefinite for neoplasia/dysplasia|
|Category 3||Non-invasive low grade neoplasia (low grade adenoma/dysplasia)|
|Category 4||Non-invasive high grade neoplasia|
| 4.1||High grade adenoma/dysplasia|
| 4.2||Non-invasive carcinoma (carcinoma in situ)|
| 4.3||Suspicion of invasive carcinoma|
|Category 5||Invasive neoplasia|
| 5.1||Intramucosal carcinoma|
| 5.2||Submucosal carcinoma or beyond|
Dr Schlemper believes that the adoption of the Vienna classification would resolve many of the inconsistencies in diagnoses by Western and Japanese pathologists.