Laryngoscopic characteristics related to the risk of cancerization of vocal cord leukoplakia

Abstract

Background

The diagnosis of vocal cord leukoplakia mainly relies on laryngoscopy. The morphology of vocal cord leukoplakia under laryngoscope is closely related to the pathological nature of leukoplakia. The specific manifestations associated with high-risk vocal cord leukoplakia remain to be explored.

Objective

To investigate the characteristics of low-risk and high-risk vocal cord leukoplakia under conventional white light imaging (WLI) laryngoscopy and its correlations with narrow band imaging (NBI) laryngoscopy.

Methods

One hundred and seventy-five cases of vocal cord leukoplakia were divided into low-risk and high-risk groups. The characteristics of low-risk and high-risk vocal cord leukoplakia under WLI laryngoscopy and its correlations with NBI laryngoscopy were analyzed.

Results

Logistic regression analysis showed that thickness and hyperemia were independent factors (p < .05). Hyperemia had a strong consistency with the visualization of spots under NBI laryngoscopy (kappa = 0.758). The sign of hyperemia and the NBI classification had equivalent diagnostic efficacy for predicting the risk of cancerization of vocal cord leukoplakia.

Conclusion

The sign of hyperemia under WLI laryngoscopy is significantly correlated with the visualized spots under NBI laryngoscopy. Hyperemia is an important feature for predicting malignant potential of vocal cord leukoplakia.

Chinese abstract

背景：声带白斑的诊断主要依靠喉镜检查。喉镜下声带白斑的形态特征与白斑的病理性质密切相关。与高危声带白斑相关的具体表现仍有待探索。

目的：通过传统白光成像 (WLI) 喉镜检查, 探讨低危和高危声带白斑的特点以及与窄带成像(NBI) 喉镜检查的相关性。

方法：将175例声带白斑患者分为低危和高危人群。 分析了WLI喉镜下低危和高危声带白斑的特点及其与 NBI 喉镜检查的相关性。

结果：逻辑回归分析显示厚度和充血是独立因素(p < .05)。NBI喉镜下, 充血与斑点可视化有很强的一致性（卡伯 ¼ 0.758）。充血征象和 NBI 分类, 对于预测声带白斑癌变的风险, 具有相等的诊断有效性。

结论：WLI喉镜下充血征象与NBI喉镜下可见的斑点具有显著相关性。充血是预测声带白斑可能恶变的重要特征。

Keywords:

• Vocal cord leukoplakia
• laryngoscopy
• narrow band imaging
• white light imaging

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Sanming Project of Medicine in Shenzhen [grant number SZSM201911008) and Beijing Hope Special Fund of Cancer Foundation of China [grant number LC2018A11].