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The updated WHO classification of digestive system tumours—gastric adenocarcinoma and dysplasia

Die aktuelle WHO-Klassifikation der Tumoren des Verdauungstrakts – Dysplasie und Adenokarzinom des Magens

  • Schwerpunkt: Gastrointestinale Pathologie
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Abstract

The fifth edition of the World Health Organization (WHO) classification of digestive system tumours was published in 2019. The classification of invasive carcinoma is basically the same as in the fourth edition, but the description of each histological type has been updated, and some rare subtypes such as micropapillary carcinoma, gastric adenocarcinoma of the fundic gland type and undifferentiated carcinoma have been added and explained. Although this classification did not provide specific numerical criteria for the diagnosis of signet-ring cell carcinoma in poorly cohesive carcinoma, an additional study defined signet-ring cell carcinoma as having more than 90% signet-ring cells. The molecular classification of gastric cancer (Epstein–Barr virus-positive type, microsatellite instability type, genomically stable type, chromosomally unstable type) was additionally introduced. Many pages in the present classification have been devoted to precancerous lesions, and this article focuses on foveolar-type adenoma/dysplasia.

Zusammenfassung

Die fünfte Ausgabe der Klassifikation von Tumoren des Verdauungssystems durch die Weltgesundheitsorganisation (WHO) wurde 2019 veröffentlicht. Dabei ist die Klassifikation invasiver Karzinome prinzipiell gleich wie in der vierten Auflage, es erfolgte aber bei der Beschreibung der histologischen Typen eine Aktualisierung und die Ergänzung einiger seltener Subtypen wie das mikropapillärer Karzinom, das Magenadenokarzinom vom Fundusdrüsentyp und das undifferenzierte Karzinom. Obwohl diese Klassifikation keine spezifischen prozentualen Kriterien für die Diagnose des Siegelringzellkarzinoms bei nichtkohäsivem Karzinom lieferte, wurde in einer zusätzlichen Studie das Siegelringzellkarzinom als mehr als 90 % Siegelringzellen enthaltend definiert. Die molekulare Klassifikation von Magenkarzinomen (Epstein-Barr-Virus-positiver Typ – Mikrosatelliteninstabilitätstyp – genomisch stabiler Typ – chromosomal instabiler Typ) wurde zusätzlich eingeführt. In der WHO-Klassifikation wurde den Präkanzerosen viel Raum gewidmet. Der vorliegende Artikel konzentriert sich auf das Adenom/die Dysplasie vom foveolären Typ.

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Change history

  • 10 December 2021

    Die Liste der Schwerpunktherausgeber wurde korrigiert.

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Authors and Affiliations

  1. Department of Pathology, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga, Japan

    R. Kushima

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  1. R. Kushima
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Correspondence to R. Kushima.

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R. Kushima declares that he has no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Schwerpunktherausgeber

H.I. Grabsch, Maastricht, Niederlande

R. Langer, Linz, Österreich

M. Vieth, Bayreuth

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Kushima, R. The updated WHO classification of digestive system tumours—gastric adenocarcinoma and dysplasia. Pathologe 43, 8–15 (2022). https://doi.org/10.1007/s00292-021-01023-7

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