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Hosri J, Aoun J, Yammine Y, Ghadieh J, Hamdan A. The sensitivity of laryngeal findings in predicting high-grade dysplasia in patients with vocal fold leukoplakia undergoing office-based biopsies: A retrospective analysis of 100 cases. Laryngoscope Investig Otolaryngol 2024; 9:e1209. [PMID: 38362176 PMCID: PMC10866589 DOI: 10.1002/lio2.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 02/17/2024] Open
Abstract
Objective To investigate the sensitivity of laryngeal findings in predicting high-grade dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC) in patients with vocal fold leukoplakia. Methods A retrospective review of the medical records and video recordings of the laryngeal examination of patients with vocal fold leukoplakia who underwent un-sedated office-based laryngeal biopsy in a tertiary referral center between January 2022 and August 2023 was conducted. Laryngeal findings included the size, surface, projection, and edges of the lesion. Vocal fold leukoplakia was classified according to the WHO as benign, low-grade dysplasia, high-grade dysplasia/CIS, and squamous cell carcinoma. Results Seventy patients with 100 vocal fold leukoplakia were included. Size was found to have the highest sensitivity with an AUC of 0.730 (95% CI [0.618-0.842], p = 0.002) followed by surface and projection with AUCs of 0.672 (95% CI [0.548-0.795], p = 0.019) and 0.675 (95% CI [0.546-0.804], p = 0.017), respectively. Furthermore, the odds of diagnosing high-risk lesions (high-grade dysplasia/CIS and SCC) were the greatest when the lesion was large and rough (OR = 10.28; 95% CI [3.08-34.36]). Conclusion The morphological features of vocal fold leukoplakia may assist the physician in predicting the risk of malignancy. Large and rough lesions were more likely to harbor high-grade dysplasia/CIS and SCC compared to small and smooth lesions.
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Affiliation(s)
- Jad Hosri
- Department of Otolaryngology‐Head and Neck SurgeryAmerican University of Beirut Medical CenterBeirutLebanon
| | - Jessica Aoun
- Department of Pathology and Laboratory MedicineAmerican University of Beirut Medical CenterBeirutLebanon
| | - Yara Yammine
- Department of Otolaryngology‐Head and Neck SurgeryAmerican University of Beirut Medical CenterBeirutLebanon
| | - Justin Ghadieh
- Faculty of MedicineAmerican University of BeirutBeirutLebanon
| | - Abdul‐Latif Hamdan
- Department of Otolaryngology‐Head and Neck SurgeryAmerican University of Beirut Medical CenterBeirutLebanon
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Campello C, Lima-Silva M, de Lima E, Nunes G, Silva H, Dellalibera E, de Britto L, Lemos C, Muniz M. Genetic polymorphisms and protein levels in vocal fold leukoplakia: a systematic review. Braz J Med Biol Res 2022; 55:e11920. [PMID: 35293553 PMCID: PMC8922550 DOI: 10.1590/1414-431x2022e11920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/13/2022] [Indexed: 12/03/2022] Open
Abstract
Vocal fold leukoplakia (VFL) has a risk of malignant transformation. Therefore, patients can have symptoms such as dysphonia, vocal strain, difficulty breathing, and dysphagia. Additionally, there is a genetic predisposition that can be associated with genetic polymorphisms. We aimed to evaluate the influence of genetic polymorphisms and protein levels in the etiology of VFL. Our study followed the PRISMA checklist and was registered on PROSPERO database. The questions were: "Are genetic polymorphisms involved in the etiology of VFL? Are protein levels altered in patients with VFL?". Eligibility criteria were case control studies that compared the presence of polymorphisms or/and protein levels of subjects diagnosed with VFL and healthy controls. Of the 905 articles retrieved, five articles with a total of 1038 participants were included in this study. The C allele of the single nucleotide polymorphisms (SNP)-819 T/C IL-10, A allele of the SNP -592 A/C IL-10, CT genotype of the SNP rs11886868 C/T BCL11A, GG genotype of the SNP rs4671393 A/G BCL11A, LL genotype, and L allele of (GT)n repeat polymorphisms of the HO-1 were risk factors for VFL development. Nevertheless, there was a lack of association between VFL and the -1082 A/G IL-10, rs14024 CK-1, and -309 T/G Mdm2 SNPs. The concentrations of the MDM2, BCL11A, and HO-1 proteins were modified, while IL-10 levels were normally expressed in these subjects. In conclusion, most markers evaluated in this review could be potential indicators to develop effective therapies, avoiding a malignant transformation of the lesion.
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Affiliation(s)
- C.P. Campello
- Programa Associado de Pós-Graduação em Fonoaudiologia,
Universidade Federal da Paraíba, João Pessoa, PB, Brasil
- Laboratório de Biologia Molecular, Centro de Oncohematologia
Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco,
Recife, PE, Brasil
| | - M.F.B. Lima-Silva
- Programa Associado de Pós-Graduação em Fonoaudiologia,
Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - E.L.S. de Lima
- Laboratório de Biologia Molecular, Centro de Oncohematologia
Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco,
Recife, PE, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de
Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brasil
| | - G.R.S. Nunes
- Programa Associado de Pós-Graduação em Fonoaudiologia,
Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - H.A.M. Silva
- Laboratório de Biologia Molecular, Centro de Oncohematologia
Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco,
Recife, PE, Brasil
- Instituto de Ciências Biológicas, Universidade de Pernambuco,
Recife, PE, Brasil
| | - E. Dellalibera
- Laboratório de Biologia Molecular, Centro de Oncohematologia
Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco,
Recife, PE, Brasil
| | | | - C.A.A. Lemos
- Departamento de Odontologia, Universidade Federal de Juiz de
Fora, Governador Valadares, MG, Brasil
| | - M.T.C. Muniz
- Laboratório de Biologia Molecular, Centro de Oncohematologia
Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco,
Recife, PE, Brasil
- Instituto de Ciências Biológicas, Universidade de Pernambuco,
Recife, PE, Brasil
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Han P, Li Y, Liang F, Ye Y, Wang J, Li X, Ouyang N, Huang X. Polymorphisms of acetaldehyde dehydrogenase 2 and alcohol dehydrogenase 1B on the malignant transformation of vocal cord leukoplakia: A Chinese cohort. Mol Carcinog 2022; 61:472-480. [PMID: 35040215 DOI: 10.1002/mc.23391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 11/05/2022]
Abstract
Severe dysplasia of vocal cord leukoplakia (VCL) is more likely to occur in laryngeal carcinoma. Alcohol dehydrogenase and acetaldehyde dehydrogenase are both important enzymes in alcohol metabolism. This study aimed to investigate the incidence rate of malignant transformation in patients with VCL and the role of drinking habits and ALDH2 and ADH1B genetic polymorphisms in the malignant transformation of VCL. From January 2007 to January 2017, 136 cases of VCL were included in this retrospective analysis. Information on medical history, alcohol and tobacco consumption habits, ALDH2 and ADH1B genotypes, gastroesophageal reflux, and clinical pathological characteristics of VCL was collected. As a result, patients had a median follow-up of 9.6 years (interquartile range: 7.5-12.5 years). Twenty-three of 136 VCL patients finally developed laryngeal carcinoma, resulting in a cumulative malignant transformation rate of 16.9%. Cox regression analysis demonstrated that the independent risk factors for the malignant transformation of VCL included age over 60 years (hazard ratio [HR]: 13.872, p < 0.001), ALDH2 *2 allele status (HR: 9.694, p < 0.001), alcohol (HR: 10.011, p < 0.001) and tobacco (HR: 8.869, p < 0.001) exposure after operation, and drinking frequency (HR: 2.178, p = 0.016). Therefore, among patients over 60 years old, an ALDH2-inactivating mutation and excessive ethanol and tobacco consumption are potential contributors to the malignant transformation of VCL.
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Affiliation(s)
- Ping Han
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yixin Li
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Otolaryngology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Faya Liang
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuchu Ye
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingyi Wang
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaojuan Li
- Department of Pathology, Cellular and Molecular Diagnostics Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Nengtai Ouyang
- Department of Pathology, Cellular and Molecular Diagnostics Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoming Huang
- Department of Otolaryngology, Head and Neck Surgery, and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Chen YL, Bao YY, Zhou SH, Yao HT, Chen Z. Relationship Between Pepsin Expression and Dysplasia Grade in Patients With Vocal Cord Leukoplakia. Otolaryngol Head Neck Surg 2020; 164:160-165. [PMID: 32692278 DOI: 10.1177/0194599820938654] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To measure pepsin expression in patients with vocal fold leukoplakia and elucidate its clinical significance. STUDY DESIGN Retrospective analysis of pathologic archive specimens. SETTING Affiliated university hospital. SUBJECTS AND METHODS The study included 45 patients with vocal fold leukoplakia and 19 with vocal fold polyps who underwent surgical treatment between December 2013 and July 2016. Masses were detected on both vocal cords in 5 patients with vocal fold leukoplakia and in 1 patient with vocal fold polyps. Immunohistochemistry was used to assess pepsin expression. In addition, the relationship of pepsin expression level with clinical characteristics of vocal fold leukoplakia was assessed. RESULTS The rate of pepsin expression was high in the polyp group (75%) and the leukoplakia group (68%); however, the difference between groups was not significant (P > .05). Pepsin expression significantly increased according to grade of dysplasia (mild, 57.1%; moderate, 88.9%; severe, 100.0%; P = .034). Similarly, the percentage of lesions that exhibited strongly positive pepsin expression increased with the grade of dysplasia (mild, 37.1%; moderate, 66.7%; severe, 100.0%; P = .005). The leukoplakia recurrence rate was higher in patients with positive pepsin expression than in patients with negative pepsin expression but without a significant difference (P > .05). CONCLUSION Our study suggests that pepsin was associated with the grade of dysplasia of vocal cord leukoplakia. Further investigation with appropriate control groups and controlling for other risk factors, such as smoking or alcohol consumption, is needed.
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Affiliation(s)
- Ya-Lian Chen
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Otolaryngology, The People's Hospital of Shengzhou City, Shengzhou, China
| | - Yang-Yang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hong-Tian Yao
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Chen
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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