Correlating intraepithelial papillary capillary loops of vocal cord leukoplakia with histopathology

Abstract

Background

The pathology of vocal fold leukoplakia (VFL) was hard to predict before surgery.

Objectives

To investigate the correlation of intraepithelial papillary capillary loops (IPCLs) with the malignant transformation in VFL.

Materials and Methods

The IPCLs in 90 patients were classified according to 2019 Ni classification. Type I–III represented to non- to moderate dysplasia in pathology being viewed as ‘benign leukoplasia’, type IV–VI represented to severe dysplasia/cancer in situ, cancerization being viewed as ‘malignant leukoplasia’. The corresponding relationship of IPCLs with pathology was calculated.

Results

Forty-one cases were classified as type I–III, the consistency of type I–III with pathology was 61.0%, with 100.0% of type I, 47.1% of type II and 30.0% of type III. 49 cases were classified as type IV–VI, all were ‘malignant leukoplasia’, the consistency of type IV–VI and pathology was 100.0%. The accuracy of type I–III, IV–VI to predict pathology were 61.0, 100.0%. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of Ni classification corresponding to ‘benign/malignant leukoplasia’ was 75.8, 100.0, 82.2, 100.0, 60.0%, respectively.

Conclusions and Significance

IPCLs of type IV–VI in vocal cord leukoplasia had a close correlation with pathology. The degree of dysplasia was underestimated in type II and type III.

Chinese Abstract

背景：声带白斑（VFL）的病理在手术前很难预测。

目的：研究上皮内乳头状毛细血管袢（IPCLs）与VFL 恶变的关系。

材料与方法：根据 2019 Ni 分类对90 例患者的 IPCLs进行分类。I-III 型代表零至中度不典型增生, 病理上被视为“良性白细胞增生症”；IV-VI 型代表严重的不典型增生/原位癌, 这种癌变被视为“恶性白细胞增生症”。计算IPCLs与病理的对应关系。

结果：41例被归类为I-III型, I-III型与病理的一致性为61.0%, 其中I型100.0%, II型47.1%, III型30.0%。 49例被归类为IV-VI型, 均为‘恶性白细胞增生症’, IV-VI型与病理的一致性为100.0%。I-III、IV-VI 型预测病理的准确率分别为 61.0、100.0%。与“良性/恶性白细胞增生症”对应的Ni分类的敏感性、特异性、准确性、阳性预测值、阴性预测值 分别为75.8%、100.0%、82.2%、100.0%、60.0%。

结论与意义：声带白细胞增生症中IV-VI型的IPCLs与病理具有紧密相关性。 II型和III型的增生程度被低估。

Keywords:

• Vocal cord leukoplakia
• narrow-band imaging
• intraepithelial papillary capillary loop: pathology

Disclosure statement

No potential conflict of interest was reported by the author(s). There is no financial relationship and interest conflict among all authors.

Additional information

Funding

This research is supported by the Science and Technology Commission of Shanghai Municipality of China [Grant NO 20Y11901900] and supported by the Health and Family Planning Commission of Shanghai Municipality of China [Grant NO 2019SY059].