Paris Classification: Early Gastric Cancer

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