Diagnostic Variability of Laryngeal Premalignant Lesions: Histological Evaluation and Carcinoma Transformation

Hu, Yanping; Liu, Honggang

doi:10.1177/0194599813516733

Cited by 15 publications

(10 citation statements)

References 25 publications

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“…A total of 18 articles with 3243 participants were included in the final systematic review, and all of these were included in the meta-analysis. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Study characteristics are shown in Table 1.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…A total of 17 studies were combined to assess the odds of malignant transformation of moderately dysplastic lesions com- pared with mildly dysplastic lesions, resulting in 640 cases of moderate dysplasia and 1032 cases of mild dysplasia (Figure 2A). [19][20][21][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Data synthesis showed that moderately dysplastic lesions had higher odds of undergoing malignant transformation compared with mildly dysplastic lesions (OR, 2.90; 95% CI, 2.06-4.09). The I 2 statistic was 0%, which indicated a low level of heterogeneity among the studies.…”

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

“…Similarly, 17 studies were combined to assess the odds of malignant transformation of severely dysplastic lesions compared with mildly dysplastic lesions (Figure 2B). [19][20][21][22][23][24][25][26][28][29][30][31][32][33][34][35][36] This resulted in 630 cases of severe dysplasia and 1038 cases of mild dysplasia. Severely dysplastic lesions showed significantly higher odds of malignant transformation compared with mildly dysplastic lesions (OR, 3.42; 95% CI, 2.11-5.52).…”

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

“…We were able to combine 9 studies to investigate the odds of malignant transformation of lesions without dysplasia compared with mildly dysplastic lesions (Figure 2C). [19][20][21][22][23]25,29,32,34 This resulted in 935 cases of nondysplastic lesions and 493 cases of mild dysplasia. Lesions without dysplasia showed significantly lower odds of malignant transformation compared with lesions with mild dysplasia (OR, 0.48; 95% CI, 0.28-0.81; I 2 = 0%).…”

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

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Malignant Transformation of Dysplastic Vocal Fold Lesions

Horton,

Philteos,

Lin

2024

JAMA Otolaryngol Head Neck Surg

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ImportanceThe reported rates of malignant transformation of dysplastic laryngeal lesions are highly variable, as is time to malignant degeneration.ObjectiveTo evaluate the rate of and time to malignant transformation of dysplastic laryngeal lesions based on the World Health Organization (WHO) dysplasia classification system.Data SourcesPubMed, MEDLINE, Embase, CINAHL, CENTRAL, and Cochrane Reviews were searched from the date of database inception to June 8, 2023.Study SelectionEnglish-language articles assessing the rate of malignant transformation using the 2005 WHO dysplasia classification system were included in this systematic review and meta-analysis.Data Extraction and SynthesisThe study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data extraction was performed by 2 independent investigators. Study quality was assessed using a validated quality tool. When possible, data were pooled using random-effects meta-analysis.Main Outcome MeasuresThe primary outcome measure was the malignant transformation rate in each laryngeal dysplasia category. Secondary outcome measure was the time interval over which malignant transformation had occurred.ResultsA total of 5585 records were screened, 61 full texts were assessed, and 18 retrospective cohort studies with 3243 participants were included in the final review. The weighted pooled mean malignant transformation rates of mildly, moderately, and severely dysplastic lesions were 10.9%, 23.3%, and 30.5%, respectively. Malignant transformation rate of nondysplastic laryngeal lesions was 4.5%. Moderately and severely dysplastic lesions had significantly higher odds of malignant transformation compared with mildly dysplastic lesions (moderate: odds ratio [OR], 2.90 [95% CI, 2.06-4.09]; I2 = 0%; severe: OR, 3.42 [95% CI, 2.11-5.52]; I2 = 40%). Lesions without dysplasia had a significantly lower odds of malignant transformation compared with lesions with mild dysplasia (OR, 0.48; 95% CI, 0.28-0.81; I2 = 0%). The overall mean time to malignant transformation was 28.8 months (range, 22.0-35.6 months) for all dysplasia grades.Conclusion and RelevanceThis systematic review and meta-analysis found that the rate of malignant transformation increased with the grade of laryngeal dysplasia. Moderately dysplastic lesions were more likely to undergo malignant degeneration compared with mildly dysplastic lesions.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

Section: Comparison Of Malignant Potential By Dysplasia Gradementioning

confidence: 99%

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Malignant Transformation of Dysplastic Vocal Fold Lesions

Horton,

Philteos,

Lin

2024

JAMA Otolaryngol Head Neck Surg

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“…[2][3][4] Early diagnosis of head and neck (HN) lesions is therefore essential to prevent the progression to invasive carcinoma. 5 Yet the categorization of HN dysplasias remains a contentious issue 6,7 due to the varying terminologies, grading methodologies, and low to moderate reproducibility among pathologists 6,8,9,10,11,12 (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis with confidence: deep learning for reliable classification of laryngeal dysplasia

Lubrano,

Bellahsen‐Harrar,

Berlemont

et al. 2023

Histopathology

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BackgroundDiagnosis of head and neck (HN) squamous dysplasias and carcinomas is critical for patient care, cure, and follow‐up. It can be challenging, especially for grading intraepithelial lesions. Despite recent simplification in the last WHO grading system, the inter‐ and intraobserver variability remains substantial, particularly for nonspecialized pathologists, exhibiting the need for new tools to support pathologists.MethodsIn this study we investigated the potential of deep learning to assist the pathologist with automatic and reliable classification of HN lesions following the 2022 WHO classification system. We created, for the first time, a large‐scale database of histological samples (>2000 slides) intended for developing an automatic diagnostic tool. We developed and trained a weakly supervised model performing classification from whole‐slide images (WSI). We evaluated our model on both internal and external test sets and we defined and validated a new confidence score to assess the predictions that can be used to identify difficult cases.ResultsOur model demonstrated high classification accuracy across all lesion types on both internal and external test sets (respectively average area under the curve [AUC]: 0.878 (95% confidence interval [CI]: [0.834–0.918]) and 0.886 (95% CI: [0.813–0.947])) and the confidence score allowed for accurate differentiation between reliable and uncertain predictions.ConclusionOur results demonstrate that the model, associated with confidence measurements, can help in the difficult task of classifying HN squamous lesions by limiting variability and detecting ambiguous cases, taking us one step closer to a wider adoption of AI‐based assistive tools.

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Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment

et al. 2018

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Diagnostic Variability of Laryngeal Premalignant Lesions: Histological Evaluation and Carcinoma Transformation

Abstract: Severe dysplasia shows the same carcinoma transformation potential as the carcinoma in situ does. Clinically, more attention to severe dysplasia is needed in comparison with mild and moderate dysplasia.

Cited by 15 publications

References 25 publications

Malignant Transformation of Dysplastic Vocal Fold Lesions

Malignant Transformation of Dysplastic Vocal Fold Lesions

Diagnosis with confidence: deep learning for reliable classification of laryngeal dysplasia

Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment

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