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CLASSIFICATION
Classification
Vienna classification (GI epithelial neoplasia)
International pathological classification of epithelial neoplasia in the esophagus, stomach, and colorectum (2000). Bridges Western (invasion-first) and Japanese (cytology-first) terminology. SNADET papers use revised Vienna C3 / C4 / C5.
Classification overview
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Category 1 · Negative for neoplasia/dysplasia
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Category 2 · Indefinite for neoplasia/dysplasia
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Category 3 · Non-invasive low-grade neoplasia
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Category 4 · Non-invasive high-grade neoplasia
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4.1 · High-grade adenoma/dysplasia
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4.2 · Non-invasive carcinoma (carcinoma in situ)
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4.3 · Suspicion of invasive carcinoma
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4.4 (2002 revision) · Intramucosal carcinoma
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Category 5 · Invasive neoplasia
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5.1 (2000) · Intramucosal carcinoma
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5.2 · Submucosal carcinoma or beyond
Non-neoplastic
Category 1
Negative for neoplasia/dysplasia
Definition
Negative for neoplasia / dysplasia
Clinical
Surveillance at the usual interval
Category 2
Indefinite for neoplasia/dysplasia
Definition
Indefinite for neoplasia / dysplasia
Clinical
Repeat biopsy after treating inflammation
Neoplastic
Category 3
Non-invasive low-grade neoplasia
Definition
Non-invasive low grade neoplasia (low grade adenoma / dysplasia)
SNADET
C3 = LGA
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
4.4 (revised)
Intramucosal carcinoma (moved from 5.1 in the 2002 revision)
SNADET
C4 usually includes HGA and intramucosal carcinoma
Note: Revised Vienna 4.4 is intramucosal carcinoma. SNADET C4 usually includes this.
Category 5
Invasive neoplasia
2000
5.1 intramucosal carcinoma; 5.2 submucosal carcinoma or beyond
2002 revision
Category 5 = submucosal carcinoma or beyond only
SNADET
C5 = SM invasive carcinoma
Note: The 2000 original also put intramucosal carcinoma in Category 5. After revision, Category 5 is SM or deeper only.
Schlemper 2000, Original
Reference
Original article
Schlemper RJ et al. Gut 2000;47:251-255
Review
Dixon 2002. Gut. Revised grouping
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