{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T18:47:07Z","timestamp":1782499627129,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The 16th edition of the Japanese Classification of Gastric Carcinoma newly distinguishes pTis from pT1a to improve international translatability with the WHO classification and UICC TNM system. However, the histologic boundary between intraepithelial neoplasia and lamina propria invasion remains difficult in routine practice. We retrospectively evaluated interobserver agreement in 50 gastric endoscopic submucosal dissection lesions randomly selected from 238 lesions previously diagnosed as intramucosal carcinoma under the 15th edition criteria. For each lesion, two representative histologic images were independently reviewed by 10 pathologists, who classified each lesion as pTis or pT1a according to predefined architectural criteria. Complete agreement was obtained in 21 lesions, including 10 unanimously diagnosed as pTis and 11 as pT1a, whereas 29 showed disagreement. Overall agreement was moderate, with a Fleiss' kappa value of 0.483. Discordant lesions involved fused or anastomosing glands, cribriform\u2010like structures, crawling or lateral expansion\u2010like patterns, and invasion mimics related to erosion, artifact, or mucosal remodeling. These findings indicate that distinguishing true invasive architecture from morphologic mimics is central to reproducible implementation of the revised classification.<\/jats:p>","DOI":"10.1111\/pin.70132","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:44:21Z","timestamp":1780292661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Morphologic Fault Lines in Distinguishing Gastric Cancer pTis From pT1a in Endoscopic Submucosal Dissection Specimens: An Interobserver Study"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6161-6704","authenticated-orcid":false,"given":"Rika","family":"Omote","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology Fukuyama Medical Center Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Okura","sequence":"additional","affiliation":[{"name":"Department of Cell Pathology, Graduate School of Medical Sciences, Faculty of Life Sciences Kumamoto University Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eita","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Ichihara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Tsushima City Hospital Tsushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6518-5574","authenticated-orcid":false,"given":"Takayuki","family":"Kodama","sequence":"additional","affiliation":[{"name":"Division of Molecular and Genomic Pathology, Department of Pathology Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-1939","authenticated-orcid":false,"given":"Akira","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Pathology Jichi Medical University Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minako","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Kyushu Medical Center Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Pathology Teikyo University Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)12249-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.47.2.251"},{"key":"e_1_2_11_4_1","unstructured":"Japanese Gastric Cancer Association Japanese Classification of Gastric Carcinoma March 2026 [The 16th Edition] (Kanehara & Co. Ltd. 2026). Japanese. ISBN: 978\u20104\u2010307\u201020507\u20108."},{"key":"e_1_2_11_5_1","unstructured":"WHO Classification of Tumours Editorial Board Digestive System Tumours. WHO Classification of Tumours Series 6th ed. (International Agency for Research on Cancer;2026)."},{"key":"e_1_2_11_6_1","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley J. 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