Management of laryngeal precancerous lesions

Stefano, Alessandro De; Marchese, Donatella; Martines, Francesco; Dispenza, Carlo

doi:10.1016/j.anl.2011.08.002

Cited by 22 publications

(15 citation statements)

References 13 publications

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“…Laryngeal lesions, of premalignant and malignant nature, have been a topic of discussion and debate focusing on laryngeal pathology. It has been proven that 90% of laryngeal cancers are preceded by precancerous lesions of leukoplakia or mucosa hypertrophy characterized histopathologically as epithelial dysplasia [7]. Therefore, identification and management of intraepithelial lesions are imperative in the prevention of invasive neoplasia.…”

Section: Discussionmentioning

confidence: 99%

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Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Rzepakowska

Žůrek

Grzybowski

et al. 2019

Eur Arch Otorhinolaryngol

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ObjectiveThe promotion of neovascularisation is a crucial aspect of carcinogenesis. The study evaluates the microvascular density (MVD) and expression of hypoxia-induced factor (HIF-1α) in hypertrophic vocal fold (VF) lesions of different histopathological states including non-dysplastic, low-grade, high-grade dysplasia and invasive glottic cancer.Materials and methodsHistological specimens collected from patients diagnosed and treated in a single centre with different histological grades were immunohistochemically stained with CD31, CD34 and HIF-1α. Of the total number of 77 analysed VF specimens, 20 were non-dysplastic, 20 had low-grade dysplasia, 17 high-grade dysplasia and 20 were invasive cancers.ResultsThe highest mean value for MVD evaluated with expression of CD31 (MVD CD31) was 21.23 ± 14.46 and identified in the low-grade dysplasia group. The average MVD CD31 was 13.74 ± 5.56 and 20.11 ± 9.28 in the high-grade dysplasia and invasive cancer group, respectively. The highest MVD evaluated with CD34 (MVD CD34) was revealed for invasive cancer 35.64 ± 17.21. The MVD CD34 was higher for low-grade than in high-grade dysplasia (25.87 ± 12.30 vs 24.65 ± 15.92, respectively). The expression of HIF-1α was strong or very strong in 60% of non-dysplastic lesions, 100% of low-grade dysplasia cases, 53% of high-grade dysplasia cases and 50% of invasive cancer cases. The comparison of MVD CD31 with MVD CD34 revealed a strong positive correlation (ρ value 0.727). The comparison of both MVD CD31 and MVD CD34 with HIF-1α resulted in no linear relationship (ρ value of 0.143 and 0.165, respectively).ConclusionThe stage of low-grade dysplasia in intraepithelial vocal fold lesions is related to significant advancement of angiogenesis together with the highest hypoxia level.Electronic supplementary materialThe online version of this article (10.1007/s00405-019-05355-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Neoangiogenesis is, therefore, inevitably preceded by a level of ischemia [4]. Hypoxia not only promotes vascular growth, but also favours the synthesis of procarcinogenic factors, including hypoxia-inducible factor (HIF-1α), which as a consequence may initiate malignant transformations [7]. …”

Section: Introductionmentioning

confidence: 99%

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Rzepakowska

Žůrek

Grzybowski

et al. 2019

Eur Arch Otorhinolaryngol

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“…1 Most patients with vocal-fold dysplasia and carcinoma in situ are treated surgically. [5][6][7][8][9][10][11] Surgery for early glottic neoplasia has largely followed the standard paradigm of resection of the tumor with a margin of normal tissue. This is usually accomplished with transoral microsurgical resection using a carbon dioxide (CO 2 ) laser.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Treating Early Glottic Neoplasms With a Potassium Titanyl Phosphate Laser

Nouraei

Dorman

Macann

et al. 2018

Ann Otol Rhinol Laryngol

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The aim of this study was to assess the outcome of treating glottic dysplasia and early squamous cell carcinoma (SCC) with potassium titanyl phosphate (KTP) photoangiolytic laser ablation. Methods: Patient demographics, comorbidities, and tumor characteristics were recorded. Perceptual, patient-reported, and objective voice outcomes were assessed. Use of treatment modalities in addition to the KTP laser, development of locoregional or metastatic SCC, and overall survival were recorded. Results: There were 23 patients with glottic dysplasia and 18 patients with glottic SCC. Mean age at treatment was 69 years. Most patients (95%) were male. Posttreatment fundamental frequency fell from 132 ± 35 to 116 ± 24 Hz (P = .03). Overall, 61% of patients achieved a normal voice. There was a learning-curve, and most treatment failures occurred in the first half of the series. Five-year KTP-only disease-control rates were 87.1% and 53.5% for dysplasia and malignancy, respectively. Five-year overall survival was 56%, with no laryngectomies or deaths due to SCC. Conclusions: Ablating dysplasia and early glottic cancer using a KTP laser is a viable treatment option. It has a learning curve and a failure rate but, in this series, no ultimate loss of oncologic control. Its introduction into clinical practice should be managed carefully in the context of multidisciplinary cancer care. Level of Evidence: 4.

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“…However, it often develops from precancerous lesions, such as epithelial hyperplasia, epidermoid metaplasia, acanthosis, keratosis, dyskeratosis, pachydermia, and dysplasia. In particular, a strong consequential relationship has been found with chronic dysplastic conditions, with higher risk of carcinoma transformation in the case of severe dysplasia grade [ 22 ]. Multiple scientific studies assessed the histopathological steps of pathology progression.…”

Section: Histopathological Features Of Lsccmentioning

confidence: 99%

Overview on Molecular Biomarkers for Laryngeal Cancer: Looking for New Answers to an Old Problem

Falco

Tammaro

Takeuchi

et al. 2022

Cancers

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Laryngeal squamous cell cancer (LSCC) accounts for almost 25–30% of all head and neck squamous cell cancers and is clustered according to the affected districts, as this determines distinct tendency to recur and metastasize. A major role for numerous genetic alterations in driving the onset and progression of this neoplasm is emerging. However, major efforts are still required for the identification of molecular markers useful for both early diagnosis and prognostic definition of LSCC that is still characterized by significant morbidity and mortality. Non-coding RNAs appear the most promising as they circulate in all the biological fluids allowing liquid biopsy determination, as well as due to their quick and characteristic modulation useful for non-invasive detection and monitoring of cancer. Other critical aspects are related to recent progress in circulating tumor cells and DNA detection, in metastatic status and chemo-refractoriness prediction, and in the functional interaction of LSCC with chronic inflammation and innate immunity. We review all these aspects taking into account the progress of the technologies in the field of next generation sequencing.

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Management of laryngeal precancerous lesions

Cited by 22 publications

References 13 publications

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Outcomes of Treating Early Glottic Neoplasms With a Potassium Titanyl Phosphate Laser

Overview on Molecular Biomarkers for Laryngeal Cancer: Looking for New Answers to an Old Problem

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