Observation of clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux
10.3760/cma.j.issn.1673-0860.2014.05.004
- VernacularTitle:声带白斑临床病理特征与咽喉反流的初步观察
- Author:
Hong ZHU
1
;
Wen XU
;
Yun LI
;
Liyu CHENG
Author Information
1. 100730,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 教育部耳鼻咽喉头颈科学重点实验室 首都医科大学
- Keywords:
Leukoplakia;
Vocal cords;
Laryngopharyngeal reflux;
Precancerous conditions;
Laryngeal neoplasms;
Carcinoma,squamous cell
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2014;(5):368-373
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux ( LRP ).Methods One hundred and thirty-eight patients with vocal leukoplakia who received laryngeal microsurgeries under suspension laryngoscope were recruited in this study.Reflux symptom index ( RSI) and reflux finding score ( RFS) were measured.The clinical features , pathological characteristics were collected.Results There were 129 males and 9 females with a mean age of ( 53.4 ±11.5 ) years.The mean age of patients with severe dysplasia/carcinoma and invasive carcinoma was significantly older than that of inflammation /hyperplasia(F=6.773,P<0.05).In 138 patients, 85 patients (61.6%) were pathologically diagnosed as chronic inflammation or squamous epithelium hyperplasia , 18 patients ( 13.0%) as mild dysplasia , 10 patients ( 7.2%) as moderate dysplasia, 15 patients (10.9%) as severe dysplasia/carcinoma in situ and 10 patients (7.2%) as invasive carcinoma.One hundred and twenty-nine patients (93.5%) complained of hoarseness with clinical courses between 7 days and 20 years.68.5% vocal folds with inflammation/hyperplasia showed nearly normal mucosal waves , and 72.7% to 80.0% vocal folds with moderate or more severe dysplasia showed severe reduced mucosal waves.A correlation existed between the severity of pathological type and the decreased extent of mucosal waves ( rank correlation coefficient was 0.427, P <0.001 ).The prevalence of LPR diagnosed with RSI >13 or RFS>7 was 54.3%, while the positive rate of RSI was 21.7%and that of RFS was 43.5%.There was no significant differences of the positive rates of RSI and RFS among different pathological types (χ2 values 3.537 and 7.619 respectively with both P >0.05 ).According to RSI evaluation, the most common reflux symptoms were hoarseness (94.9%), throat clearing (68.8%) and globus sensation ( 62.3%).The most common RFS findings were posterior commissure hypertrophy (79.7%), thick endolarygeal mucus (77.5%) and vocal fold edema (70.3%).Conclusions The vocal fold leukoplakia consisted of various pathological types including benign , dysplasia and malignancy.There was a correlation between pathological types and the extent of mucosal waves .About half of the patients with vocal fold leukoplakia existed LPR using RFS and RSI evaluation , but no significant difference of LPR positive rates were observed among different pathological types.
