Analyses of pathogenic factors and clinicopathological characteristics of vocal leukoplakia
10.3760/cma.j.issn.1673-0860.2018.08.005
- VernacularTitle: 声带白斑的发病因素及临床特点分析
- Author:
Wenlun WANG
1
;
Lihong ZHANG
1
;
Jie CAO
1
;
Chaofan LI
1
;
Yuguang WANG
1
;
Yixin ZHAO
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital, Beijing 100044, China
- Publication Type:Journal Article
- Keywords:
Vocal cords;
Leukoplakia;
Laryngopharyngeal reflux;
Pathology;
Pathogenic factors;
Recurrence
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2018;53(8):581-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the pathogenic factors of vocal leukoplakia and its clinical and pathological features.
Methods:Eighty-one patients with vocal cord leukoplakia who underwent surgery between February 2010 and December 2016 and 160 volunteers without pharyngeal symptoms designed as controls were included in this case control study. The clinicopathological characteristics of 81 patients were summarized and analyzed synthetically.
Results:There was statistical significance in reflux symptom index(RSI), reflux finding score(RFS), smoking index, and drinking index between case group and control group(Z=-5.35, -4.82, -4.76, -2.44, P<0.05). The voice-using duration per day in case group was significantly longer than that of control group.There was no statistical significance in hospital anxiety and depression scale for anxiety(HADA) scores、hospital anxiety and depression scale for depression(HADD) scores between case group and control group(P>0.05). In 42 patients who received 24-hour dual probe pH monitoring the prevalence of pathologic LPR was 42.8%. In 81 patients, 39(48%)patients were pathologically diagnosed as squamous cell hyperplasia, 18(22%)patients as mild dysplasia, 12(15%)sides as moderate dysplasia , 10(12%)patients as severe dysplasia and 2(2%)patients as carcinoma in-situ. The average age of high-risk pathological vocal leukoplakia was significantly higher than that of low-risk leukoplakia(t=-2.73, P<0.01). The propotion of speckled leukoplakia in high-risk leukoplakia was significantly higher than that of low-risk leukoplakia(χ2=23.81, P<0.01). There was no statistical significance between high-risk leukoplakia and low-risk leukoplakia in the prevalence of pathologic LPR(P>0.05). The bilateral lesions, speckled leukoplakia were more likely to relapse(χ2=4.27, 12.17, P<0.05). The more serious the pathology, the more likely it was to relapse (Z=-2.168, P=0.03). There was no statistical significance between recurrence group and non-recurrence group in the prevalence of pathologic LPR(P>0.05).
Conclusions:LPR, smoke constitute the risk factors of vocal cord leukoplakia. Drinking, voice abuse are related to vocal cord leukoplakia. Senile, speckled leukoplakia are more likely to be malignancy. A speckled leukoplakia, bilateral leukoplakia, severe pathological degree are important factors to predict recurrence.
