胃生検組織診断分類（Group分類）の問題点―アンケート調査による検証

Problems of Group Classification (GC) for Gastric Biopsy Specimens―Results of a Questionnaire about the Problems of GC

要旨　胃生検組織診断分類（Group分類）が世に出て30年余となり，Group分類が内在する矛盾点や欧米の診断基準との整合性が問題となっている．病理医のGroup分類に対する考え方の実態調査が必要と考えられ，電子メールを用いたアンケート調査が行われた．全国ほぼ均等に病院，大学，検査所等から152通のアンケート回答を得た．その結果，Group分類は全国で病理医にとって便利だから用いられている，Group IIIは腺腫や良性・悪性境界領域病変に用いられ，Group IVは質，量不足，また躊躇して癌としないときに用いられている，Group分類の改訂には賛成あるいはどちらでもよいとの意見が多く，改訂は国際的な分類にという意見が多いが，Vienna分類には関心のない病理医が多い，という実態であった．

　Group classifications (GC) for gastric biopsy specimensfirst appeared in 1971. Recently, differences between Japanese and Western pathologists regarding diagnoistic criteria for gastrointestinal epithelial neoplasia have given rise to controversy. The GC needs to be reviewed in light of its inherent problems, and its inconsistencies with the Vienna Classification (VC). Under these circumstances, opinions of Japanese pathologists about the above problems have been collected by an e-mail questionnaire using the internet. The questionnaire about the problems of GC resulted in the collated responses of 152 Japanese pathologists who most routinely used the GC. They complained about the unclear definition of Group III of the GC, and were positive about revising the GC to an internationally accepted form, but they had little interest in the VC.

　1) Department of Diagnostic Pathology, Iwate Medical University, Morioka, Japan

　2) Department of Pathology, Cancer Institute of Japanese Foundation for Cancer Research, Tokyo