| International Session (Workshop) 1 (JGES・JSGE) |
| Sat. November 3rd 9:00 - 12:00 Room 13: Kobe International Conference Center International Conference Room |
| International evaluation of endoscopic classification JNETIEE-JNET | |||
| Thierry Ponchon | |||
| Digestive Disease Department, Edouard Herriot Hospital | |||
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| The Japanese Gastroenterological Endoscopy Society (Pr Hisao Tajiri) and Pr Yutaka Saito have approached the European Society of Gastrointestinal Endoscopy (ESGE) to organize an international evaluation of the endoscopic classification JNETIEE-JNET. The rationale of such evaluation is simple : In Europe, NBI has gained progressive popularity in case of Barrett's esophagus and colorectal polyps. NICE (NBI international colorectal endoscopic) classification has been adopted to distinguish adenoma and hyperplastic polyps in order to apply the discard policy. Mainly the left part of the NICE classification (TYPE 1 versus type 2) has been evaluated and applied progressively. Equivalent classifications to NICE have been developped with alternative technologies (BASIC, SIMPLE, …). The right part of NICE classification (Type 2 vs type 3) is more rarely used in Europe and has been not well evaluated for several reasons : the role of electronic chromoendoscopy to rule out a carcinomatous component within an adenoma and to evaluate the depth of carcinomatous invasion is not well known in Europe. The need is also little as endoscopic submucosal dissection is limited to few centers and only begins to be used for colorectal lesions. And finally cresyl violet is not used and recommended in Europe. Thus the classification launched in 2011 by the Japan NBI Expert Team (JNET) which aimed to subdivide type 2 in type 2A (high-grade intramucosal neoplasia/shallow submucosal invasive cancer) and type 2B (deep submucosal invasive cancer) did not reach Europe and seems to be too sophisticated for european endoscopists. Despite there is a real need in order to select the best approach for the endoscopic resection of LST : EMR, ESD or surgery. In order to promote JNET classification outside Japan, JGES wishes first to see if non japanese could accurately use JNET and then selected Europe and ESGE to conduct such evaluation due to the increasing interest in Europe for electronic chromoendoscopy and for ESD. A working group has been established with H Messmann, E Dekker and M. Pioche for the european side, and the modalities of the evaluation are under discussion (which main endpoint ?, which lesions ?....) |
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