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Clinicopathological parameters associated with histological background and recurrence after surgical intervention of vocal cord leukoplakia.

Abstract Histological examination of biopsy shows usefulness in the diagnosis of vocal cord leukoplakia; however, in considerable amount of cases, the examination cannot provide definitive diagnosis of malignancy from benign conditions such as hyperplasia and dysplasia. The present work therefore was aimed to identify clinicopathological factors and molecular markers predictive of recurrence and malignant transformation of vocal cord leukoplakia.Clinical data of 555 cases of vocal cord leukoplakia enrolled from July 1999 to June 2014 were analyzed. The cohort consisted of keratosis (n = 137), hyperplasia (n = 139), dysplasia (n = 177), and primary (n = 10) and invasive (n = 46) carcinoma. Correlations between patients' backgrounds, clinicopathological factors, molecular markers (p53, p16, Ki67, cytokeratin, and proliferating cell nuclear antigen), and histology backgrounds were examined using by Pearson Chi-squared or Fisher exact test. Reflux symptom index (RSI) and reflux finding score (RFS) before and after treatment were compared using Wilcoxon signed-rank test. Risk factors for disease recurrence were identified using Cox proportional hazards models of multivariate analysis. Time to recurrence was analyzed using log-rank test of Kaplan-Meier method.In the present cohort, alcohol drinking was found associated with GRBAS grade (P = .0258) and the site (P = .0298) of leukoplakia. For the different disease types, chief complaint (P = .0179), GRBAS grade (P = .0101), mucosal wave (P < .0001), and molecular markers p53 (P < .0001) and Ki67 (P < .0001) were identified as correlates. RSI and RFS were significantly lowered by surgical intervention. A single side of leukoplakia was predictive of a lower risk of recurrence (odds ratio, 0.378; 95% confidence interval, 0.197-0.723; P = .0033). Absence of mucosal wave was associated with a shorter time-to-recurrence (P = .0357).The present work identified clinicopathological factors and molecular markers associated with the different histology of vocal cord leukoplakia, and also the prognostic factor for the low risk of recurrence after surgery.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28562558
OWN - NLM
STAT- MEDLINE
DA  - 20170531
DCOM- 20170630
LR  - 20170630
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 22
DP  - 2017 Jun
TI  - Clinicopathological parameters associated with histological background and
      recurrence after surgical intervention of vocal cord leukoplakia.
PG  - e7033
LID - 10.1097/MD.0000000000007033 [doi]
AB  - Histological examination of biopsy shows usefulness in the diagnosis of vocal
      cord leukoplakia; however, in considerable amount of cases, the examination
      cannot provide definitive diagnosis of malignancy from benign conditions such as 
      hyperplasia and dysplasia. The present work therefore was aimed to identify
      clinicopathological factors and molecular markers predictive of recurrence and
      malignant transformation of vocal cord leukoplakia.Clinical data of 555 cases of 
      vocal cord leukoplakia enrolled from July 1999 to June 2014 were analyzed. The
      cohort consisted of keratosis (n = 137), hyperplasia (n = 139), dysplasia (n =
      177), and primary (n = 10) and invasive (n = 46) carcinoma. Correlations between 
      patients' backgrounds, clinicopathological factors, molecular markers (p53, p16, 
      Ki67, cytokeratin, and proliferating cell nuclear antigen), and histology
      backgrounds were examined using by Pearson Chi-squared or Fisher exact test.
      Reflux symptom index (RSI) and reflux finding score (RFS) before and after
      treatment were compared using Wilcoxon signed-rank test. Risk factors for disease
      recurrence were identified using Cox proportional hazards models of multivariate 
      analysis. Time to recurrence was analyzed using log-rank test of Kaplan-Meier
      method.In the present cohort, alcohol drinking was found associated with GRBAS
      grade (P = .0258) and the site (P = .0298) of leukoplakia. For the different
      disease types, chief complaint (P = .0179), GRBAS grade (P = .0101), mucosal wave
      (P &lt; .0001), and molecular markers p53 (P &lt; .0001) and Ki67 (P &lt; .0001) were
      identified as correlates. RSI and RFS were significantly lowered by surgical
      intervention. A single side of leukoplakia was predictive of a lower risk of
      recurrence (odds ratio, 0.378; 95% confidence interval, 0.197-0.723; P = .0033). 
      Absence of mucosal wave was associated with a shorter time-to-recurrence (P =
      .0357).The present work identified clinicopathological factors and molecular
      markers associated with the different histology of vocal cord leukoplakia, and
      also the prognostic factor for the low risk of recurrence after surgery.
FAU - Cui, Weixin
AU  - Cui W
AD  - Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren
      Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and
      Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.
FAU - Xu, Wen
AU  - Xu W
FAU - Yang, Qingwen
AU  - Yang Q
FAU - Hu, Rong
AU  - Hu R
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Ki-67 Antigen)
RN  - 0 (Tumor Suppressor Protein p53)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Alcohol Drinking/metabolism/pathology
MH  - Biomarkers, Tumor/metabolism
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Ki-67 Antigen/metabolism
MH  - Laryngeal Neoplasms/metabolism/*pathology/*surgery
MH  - Leukoplakia/metabolism/*pathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/metabolism/pathology
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Tumor Suppressor Protein p53/metabolism
MH  - Vocal Cords/metabolism/*pathology/*surgery
MH  - Young Adult
PMC - PMC5459723
EDAT- 2017/06/01 06:00
MHDA- 2017/07/01 06:00
CRDT- 2017/06/01 06:00
AID - 10.1097/MD.0000000000007033 [doi]
AID - 00005792-201706020-00034 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(22):e7033. doi: 10.1097/MD.0000000000007033.