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Paris Classification: Early Gastric Cancer

Alexander Meining (Ulm) and Thomas Rösch (Hamburg)

The Paris classification of superficial tumors, which is presented and discussed in detail in the introductory section, should be used in standard endoscopic terminology. A diagram of the classification is shown again below: Examples of superficial/early gastric tumors are shown below. In the stomach, flat lesions are predominant, often as combined lesions with a central depression (IIa+c). Sessile tumors with substantial intraluminal growth are often no longer early cancers; the same is the case with significantly excavated lesions (type III).

Examples in the stomach, 1: type Is, elevated

Examples in the stomach, 2: type IIa, flat and elevated

Surprisingly, the histology in this case showed deep submucosal infiltration.

Examples in the stomach, 3: type IIa+c, flat and elevated with a central depression

Examples in the stomach, 4: type IIb, flat

Examples in the stomach, 5: type IIc, depressed

Examples in the stomach, 6: type III, ulcerated

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