Prognostic Role of the Initial Grade of Dysplasia on Premalignant Vocal Fold Lesions

IF 2.5 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice Pub Date : 2025-01-01 DOI:10.1016/j.jvoice.2022.07.015

João Viana Pinto , José João Ruas , João Aragão Rodrigues , Isabel Pinto , Manuel Leal , Fernando Vales , Carla Pinto Moura

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引用次数: 0

Abstract

Purpose

The main objective of this study was to analyze the prognostic role of the initial grade of dysplasia on the progression to SCC.

Study Design

Retrospective cohort.

Methods

This study was performed in the Otorhinolaryngology Department of a tertiary hospital center from January 2010 to December 2020. Every patient submitted to a microlaryngoscopy during this period with a histology of dysplasia on the first biopsy was included.

Results

A total of 112 patients were included and median follow-up was 24 months (range 1–120 months). Mean age at diagnosis was 59.71 (+/- 12.03) and 88 patients were male (78.6%). Initial grade of dysplasia was mild on 60 patients (53.6%), moderate on 24 (21.4%), severe on 18 (16.1%), and carcinoma in situ in 10 (8.9%). Overall, 25 patients (21.4%) developed invasive squamous cell carcinoma (SCC) and 15 (13.4%) died during follow-up. On an adjusted 5 year's progression free survival analysis, considering gender, age, dysplasia grade, tobacco and alcohol consumption, the initial grade of dysplasia was the only factor significantly associated with progression to carcinoma (P = .047). When compared to mild dysplasia, moderate dysplasia had a Hazard Ratio (HR) of 0.81 (95%CI 0.21–3.22); severe dysplasia had a HR of 1.76 (95%CI 0.59–5.30) and carcinoma in situ had a HR of 4.25 (95%CI 1.44–12.59).

Conclusion

The initial dysplasia grade seems to be the most important prognostic factor regarding progression to SCC in patients with premalignant vocal fold disease.

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声带增生初期等级对恶性声带病变的预后作用

目的：本研究的主要目的是分析最初的发育不良等级对发展为 SCC 的预后作用：研究设计：回顾性队列：本研究于 2010 年 1 月至 2020 年 12 月在一家三级医院中心的耳鼻喉科进行。在此期间接受显微咽喉镜检查且首次活检组织学结果为发育不良的所有患者均被纳入研究范围：结果：共纳入 112 名患者，中位随访时间为 24 个月（1-120 个月）。诊断时的平均年龄为 59.71 (+/- 12.03)，88 名患者为男性（78.6%）。60 名患者（53.6%）的最初发育不良等级为轻度，24 名（21.4%）为中度，18 名（16.1%）为重度，10 名（8.9%）为原位癌。总体而言，25 名患者（21.4%）发展为浸润性鳞状细胞癌（SCC），15 名患者（13.4%）在随访期间死亡。考虑到性别、年龄、发育不良等级、吸烟和饮酒情况，调整后的5年无进展生存分析显示，最初的发育不良等级是唯一与癌变进展显著相关的因素（P = .047）。与轻度发育不良相比，中度发育不良的危险比（HR）为0.81（95%CI 0.21-3.22）；重度发育不良的危险比为1.76（95%CI 0.59-5.30）；原位癌的危险比为4.25（95%CI 1.44-12.59）：结论：最初的发育不良等级似乎是声带癌前病变患者发展为 SCC 的最重要预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Voice 医学-耳鼻喉科学

CiteScore

4.00

自引率

13.60%

发文量

395

审稿时长

59 days

期刊介绍： The Journal of Voice is widely regarded as the world''s premiere journal for voice medicine and research. This peer-reviewed publication is listed in Index Medicus and is indexed by the Institute for Scientific Information. The journal contains articles written by experts throughout the world on all topics in voice sciences, voice medicine and surgery, and speech-language pathologists'' management of voice-related problems. The journal includes clinical articles, clinical research, and laboratory research. Members of the Foundation receive the journal as a benefit of membership.