Colorectal Cancer
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 15, 2003; 9(9): 1985-1989
Published online Sep 15, 2003. doi: 10.3748/wjg.v9.i9.1985
Differences in endoscopic classification of early colorectal carcinoma between China and Japan: A comparative study
Ren-Min Zhu, Fang-Yu Wang, Ichiro Hirata, Ken-Ichi Katsu, Shu-Dong Xiao, Zhong-Lin Yu, Zhi-Hong Zhang, Zhao-Min Xu
Ren-Min Zhu, Fang-Yu Wang, Department of Gastroenterology, Jinling Hospital, Nanjing 210002, Jiangsu Provincce, China
Ichiro Hirata, Ken-Ichi Katsu, The Second Department of Internal Medicine, Osaka Medical College, Takatsuki 569-8686, Osaka, Japan
Shu-Dong Xiao, Shanghai Institute of Digestive Diseases, Shanghai 200001, China
Zhong-Lin Yu, Department of Gastroenterology, Capital Medical University, Beijing 100050, China
Zhi-Hong Zhang, Zhao-Min Xu, Department of Gastroenterology, Gulou Hosiptal, Nanjing 210008, China
Author contributions: All authors contributed equally to the work.
Supported by Japan-China Sasagawa Medical Fellowship (1999, 22th)
Correspondence to: Ren-Min Zhu, Department of Gastroenterology, Jinling Hospital, Nanjing 210002, Jiangsu Province, China. wangf65@yahoo.com
Received: May 11, 2003
Revised: May 23, 2003
Accepted: June 2, 2003
Published online: September 15, 2003
Abstract

AIM: To compare the differences in the endoscopic classification of early colorectal carcinoma (CRC) between Japan and China.

METHODS: Ten cases of early CRC were included in the study. After reviewing the color pictures of these cases, 5 Japanese endoscopists and 5 Chinese endoscopists made their classificatory diagnosis individually using the current Japanese classification, and indicated their findings on which the diagnosis was based.

RESULTS: Some lesions diagnosed by the Japanese endoscopists as IIa or IIa plus IIc, were classified as Is or Isp by the Chinese endoscopists. For superficial lesions consisting of elevation plus central depression, IIa plus depression, IIa plus IIc or IIc plus IIa were classified according to the ratio of elevated area/depressed area. However, international as well as interobserver difference still existed in the classification of such lesions. In addition, most Chinese endoscopists overlooked slightly depressed part on the top of a protruded lesion. Laterally spreading tumor, a special type of IIa, was identified as LST by some Japanese endoscopists.

CONCLUSION: Discrepancies on macroscopic classification for early CRC do exist between Japanese and Chinese endoscopists, which are found not only in terminology but also in recognition of some lesions. In order to develop a universal classification, it needs for international communication and cooperation.

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