A Correlation Study On The Morphological Classification Of Vocal Cord Leukoplakia And Pathological Diagnosis Based On The Laryngoscope

Objective:To explore the correlation between the morphological classification of vocal cord leukoplakia under electronic laryngoscope and its pathological diagnosis.Methods:The clinical data of 91 patients with vocal cord leukoplakia admitted from January 2011 to November 2018 were retrospectively analyzed,including complete electronic laryngoscope image data and histopathological diagnosis data.Among them,there were 51 cases of unilateral vocal cord lesions,40 cases of bilateral vocal cord lesions,and totaling 131 lateral vocal cord leukoplakia.The morphology of vocal cord leukoplakia under electronic laryngoscope images could be divided into three patterns: 1.Smooth light-colored pattern,2.White thickening pattern,3.Irregular and rough pattern.According to the degree of dysplasia of vocal cord epithelial tissue,the histopathological results were divided into groups I to V,corresponding to group I: Nondysplasia group,group II: Mild dysplasia group,group III: Moderate dysplasia group,group IV: Severe dysplasia group,group V: Carcinogenesis group.Three kinds of morphological classification of vocal cord leukoplakia under electronic laryngoscope and their corresponding histopathological results were analyzed and compared.Result:There were 85 cases for male and 6 cases for female in the 91 patients with vocal cord leukoplakia,and the proportion of male and female was 14.17: 1.The average age of 91 patients was 56.43 ± 11.51 years old.The average age of men was 56.07 ± 11.33 years old and that of women was 46.33 ± 11.06 years old.Conduct the morphological classification of 131 patients with lateral vocal cords,it showed: 70 cases in lateral smooth light-colored pattern,29 cases in lateral white and thickened pattern,and 32 cases in lateral irregular and rough pattern.As for the consistency of the three morphological classifications of vocal cord leukoplakia,the two otolaryngologists assessed normal,better,and better respectively(? values were 0.31,0.61,0.71,P < 0.01).There were significant differences in reliability test results between assessors.Grouping pathological results: There were 24(18.32%)lateral vocal cords in nondysplasia group,57(43.51%)lateral vocal cords in mild dysplasia group,13(9.92%)lateral vocal cords in moderate dysplasia group,13(9.92%)lateral vocal cords in severe dysplasia group,and 24(18.32%)lateral vocal cords in carcinogenesis group.It was significant differences in histopathology between the morphological classification of vocal cord leukoplakia among the three groups(P<0.01).In the smooth light-colored pattern,the nondysplasia group and mild dysplasia were 91.43%,which were 1.89 times and 9.75 times of the white thickened leukoplakia and irregular rough leukoplakia respectively.Severe dysplasia group and carcinogenesis group account for only 2.86% of this pattern.The proportion of nondysplasia and mild dysplasia was 48.28%,while that of severe dysplasia and carcinogenesis group was 24.14%.In the irregular and rough leukoplakia,the proportion of severe dysplasia and carcinogenesis was 87.5%,which was 30.63 times and 3.63 times of smooth light-colored pattern and white thickening pattern respectively,and only 9.38% in nondysplasia group and mild dysplasia group.Conclusion:Vocal cord leukoplakia is prone to elderly men.According to the morphology of vocal cord leukoplakia under electronic laryngoscope,it can be divided into smooth light-colored type,white thickening type and irregular rough type.The pathology of smooth light-colored pattern is common in nondysplasia and mild dysplasia,which is the manifestation of benign lesions of vocal cord leukoplakia.The pathology of white thickening pattern is common in moderate and severe dysplasia,which is a proliferative lesion with further development of the lesion.The pathology of irregular and rough pattern is characterized by severe dysplasia and carcinogenesis,which are severe dysplasia or malignant change of vocal cord epithelium.Through the three kinds of morphological classification under laryngoscope,it can be roughly judged whether the vocal fold leukoplakia is benign or malignancy,the degree of epithelial dysplasia,and the probability of carcinogenesis,of vocal cord leukoplakia,so as to provide a certain reference for the choice of therapeutic schemes for vocal cord leukoplakia.