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Comparison of the Laurén[1], Nakamura[2], Japanese Gastric Cancer Association (JGCA)[3], and World Health Organization (WHO) classifications[4]

Comparison of the Laurén[1], Nakamura[2], Japanese Gastric Cancer Association (JGCA)[3], and World Health Organization (WHO) classifications[4]
Laurén (1965)* Nakamura et al (1968) JGCA (2017) WHO (2019)
Intestinal Differentiated Papillary: pap Papillary
Tubular 1, well-differentiated: tub1 Tubular, well-differentiated
Tubular 2, moderately differentiated: tub2 Tubular, moderately differentiated
  Undifferentiated Poorly 1 (solid type): por1 Tubular (solid), poorly differentiated
Diffuse Undifferentiated Signet-ring cell: sig Poorly cohesive, signet-ring cell phenotype
Poorly 2 (non-solid type): por2 Poorly cohesive, other cell types
  Differentiated/undifferentiated Mucinous Mucinous
Mixed Undifferentiated Description according to the proportion (eg, por2 > sig > tub2) Mixed
  Not defined Special type:
  • Adenosquamous carcinoma
  • Squamous cell carcinoma
  • Undifferentiated carcinoma
  • Carcinoma with lymphoid stroma
  • Hepatoid adenocarcinoma
  • Adenocarcinoma with enteroblastic differentiation
  • Adenocarcinoma of fundic gland type
 Other histological subtypes:
  • Adenosquamous carcinoma
  • Squamous cell carcinoma
  • Undifferentiated carcinoma
  • Carcinoma with lymphoid stroma
  • Hepatoid carcinoma
  • Adenocarcinoma with enteroblastic differentiation
  • Adenocarcinoma of fundic gland type
  • Micropapillary adenocarcinoma
* Cases equally composed of both intestinal and diffuse components are reported as mixed carcinomas. The term indeterminate carcinoma is used for cases that cannot be adequately classified.
References:
  1. Laurén P. The two histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma. An attempt at a histoclinical classification. Acta Pathol Microbiol Scand 1965; 64:31.
  2. Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gan 1968; 59:251.
  3. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 15th ed, Kanehara Shuppan 2017 (in Japanese).
  4. Kushima R, Lauwers GY, Rugge M. Gastric Dysplasia. In: WHO Classification of Tumours: Digestive Systemic Tumours, 5th, WHO Classification of Tumours Editorial Board (Ed), International Agency for Research on Cancer 2019.
Adapted with permission. Table 9-2, from Odze RD, Montgomery EA, Wang HH, et al. Tumors of the Esophagus and Stomach. Atlas of Tumour Pathology. American Registry of Pathology, Arlington, VA 22209.
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