Immunohistological comparison of the World Health Organization (WHO) and Ljubljana classifications on the grading of preneoplastic lesions of the larynx

Şengiz, Selma; Pabuçcuoğlu, Uğur; Sarıoğlu, Sülen

doi:10.1016/j.prp.2003.11.002

Cited by 19 publications

(8 citation statements)

References 38 publications

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“…Previous studies have suggested that the molecular basis for LC classification for laryngeal neoplastic progression is stronger than for the others [21][22][23][24]. This series presents data about IA of WHOC, and novel information about LC and SINC of laryngeal pre-neoplastic lesions.…”

Section: Discussionmentioning

confidence: 93%

Inter-observer Agreement in Laryngeal Pre-neoplastic Lesions

Sarıoğlu

Çakalağaoğlu²,

Elagöz

et al. 2010

Head and Neck Pathol

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In this series, laryngeal preneoplastic lesions were evaluated by the classifications of the World Health Organization (WHOC), Ljubljana (LC) and squamous intraepithelial neoplasia (SINC) by multiple observers. The inter-observer agreement (IA) by WHOC for laryngeal lesions had been previously evaluated, but to the best of our knowledge, there are no data for LC and SINC. H&E stained slides from 42 laryngeal biopsies were evaluated by fourteen participants according to WHOC and LC, and SINC was additionally applied by 6. The results were analyzed statistically. The diagnoses which were favored by most participants for each case, according to WHOC, were as follows: squamous cell hyperplasia (n = 5; 12%), mild dysplasia (n = 11; 26.2%), moderate dysplasia (n = 12; 28.6%), severe dysplasia (n = 7; 16.7%), carcinoma in situ (n = 5; 12%), and invasive squamous cell carcinoma (n = 2; 4.8%). There was a significant difference between the participants for all three classifications; some participants gave lower or higher scores than the others. The mean correlation coefficients (MCC) of the participants were higher for WHOC compared to LC (0.55 ± 0.15 and 0.48 ± 0.14, respectively). The mean linear-weighted kappa (wKappa) values of participants were not significantly different (0.42 ± 0.10, 0.41 ± 0.12 and 0.37 ± 0.07 for WHOC, LC and SINC, respectively). The kappa values in this series are in agreement with those in previous literature for WHOC, and the similar results obtained for LC and SINC are novel findings. Although the MCC of WHOC was higher, as the wkappa was not significantly different, the findings in this series are not in favor of any of the classifications for better IA for preneoplastic laryngeal lesions.

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Section: Discussionmentioning

confidence: 93%

Inter-observer Agreement in Laryngeal Pre-neoplastic Lesions

Sarıoğlu

Çakalağaoğlu²,

Elagöz

et al. 2010

Head and Neck Pathol

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“…One study stained cells for p53, CD34, and Ki-67 to stratify the severity of dysplasia in a different classification scheme, but these stains did not seem to perform significantly better than the World Health Organization classification. 15 Survivin has been previously studied in RRP. Survivin is a member of the inhibitor of apoptosis family of proteins expressed in papilloma cells but not in normal laryngeal tissue, and it functions in cell survival and proliferation.…”

Section: Resultsmentioning

confidence: 99%

ProEx C Stain Analysis in Recurrent Respiratory Papillomatosis

Bhandarkar¹,

Sims²,

David³

2010

Ann Otol Rhinol Laryngol

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“…These grading systems have been evaluated for their prognostic utility with the assumption that mild atypical changes will have a lower risk for transformation to invasive carcinoma than those with advanced or severe changes. In the larynx, the most frequently employed systems in use among pathologists include the World Health Organization (WHO) and the Ljubljana Grading systems for vocal cord lesions; oral precancerous lesions are typically classified according to WHO [3–6]. The WHO grading system for both vocal cord and oral mucosa divides dysplasia into three categories, with the realization that dysplastic change is in reality a dynamic process.…”

Section: Grading Systemsmentioning

confidence: 99%

Dysplasia of the Upper Aerodigestive Tract Squamous Epithelium

Eversole¹

2009

Head and Neck Pathol

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Dysplasia of the oral, laryngeal and oropharyngeal stratified squamous epithelia is a microscopically defined change that may occur in clinically identifiable lesions including erythroplakia, leukoplakia and erythroleukoplakia, lesions that convey a heightened risk for carcinomatous progression. Dysplastic lesions have been classified microscopically according to degree of cytologic atypia and changes in architectural patterns, usually on a three part or four part gradation scale. Vocal cord epithelial lesions are graded according to either the Ljubljana or the World Health Organization (WHO) system whereas oral dysplasias are generally classified according to WHO criteria. Cytologically atypical cells are considered to represent precancerous changes predicting an increase risk for carcinomatous transformation. Inter- and intra-rater reliability studies among pathologists have disclosed low correlation coefficients for four part grading systems, whereas improved agreement is achieved (kappa correlation values) using the Ljubljana systems. Evidence forwarded by some studies supports the prognostic value of progressively severe dysplastic changes for carcinomatous transformation; however, some studies indicate that the presence of a clinically defined lesion without microscopic evidence of dysplasia also connotes increased risk for carcinomatous transformation. Loss of heterozygosity (LOH) at 3p and 9p microsatellite domains, DNA ploidy analysis and nuclear image analyses may have predictive value as molecular and histomorphological biomarkers.

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Immunohistological comparison of the World Health Organization (WHO) and Ljubljana classifications on the grading of preneoplastic lesions of the larynx

Cited by 19 publications

References 38 publications

Inter-observer Agreement in Laryngeal Pre-neoplastic Lesions

Inter-observer Agreement in Laryngeal Pre-neoplastic Lesions

ProEx C Stain Analysis in Recurrent Respiratory Papillomatosis

Dysplasia of the Upper Aerodigestive Tract Squamous Epithelium

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