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Journal of voice : official journal of the Voice Foundation · 2019

Morphology, Vibratory Function, and Vascular Pattern for Predicting Malignancy in Vocal Fold Leukoplakia.

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Rzepakowska Anna, Sobol Maria, Sielska-Badurek Ewelina, Niemczyk Kazimierz, Osuch-Wójcikiewicz Ewa

Аннотация

BACKGROUND: The study evaluates clinical features of vocal fold (VF) leukoplakia in predicting its benign or malignant nature.

MATERIALS: 57 patients with 84 lesions were evaluated before undergoing laryngeal microsurgery. The texture, color, thickness and size of the leukoplakia, along with an assessment of the surrounding mucosa vascularization using narrow-band imaging (NBI), and VF vibratory function were analyzed. Receiver-operating characteristic curves were constructed to determine the predictive value of each feature and area under the curve (AUC) was calculated.

RESULTS: Histopathological examination revealed high-grade dysplasia or invasive cancer in 13 of VF leukoplakia. Seventy-one lesions were nondysplastic or low-grade dysplasia. Nonhomogenous color, irregular texture, and prominent thickness predicted malignancy with statistical significance (P < 0.05). AUC was 0.793, 0.793, and 0.679, respectively. Absence of a mucosal wave on laryngovideostroboscopy was significant for the detection of malignancy (P < 0.001) with an AUC of 0.927. The NBI diagnosis of horizontal vessel loops was significant with the highest AUC of 0.993.

CONCLUSIONS: The comprehensive clinical evaluation of VF leukoplakia with laryngovideostroboscopy and NBI creates the opportunity to differentiate between low- and high-risk malignancy lesions. The perpendicular vascular pattern and the limited or absent mucosal wave appear to be the most powerful indicators of malignancy.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты