‘Risky’ epithelium in the larynx — a practical diagnosis?

Helliwell, Tim

doi:10.1046/j.1365-2559.1999.00631.x

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…However, due to the continuous increase in proliferative activity, we were not able to define a clear-cut level of MIB-1 for distinction between prognostically important groups, especially not for the crucial step from benign to risky epithelium. This was criticized also in a review of other studies [19]. Our investigation revealed a high incidence of p53 immunoreactive lesions in comparison to others [7, 20], even within the SH group.…”

Section: Discussioncontrasting

confidence: 68%

The Supplementary Diagnostic Power of Selected Immunohistochemical, Molecular Genetic and Infective Parameters in Epithelial Hyperplastic Laryngeal Lesions

Kleist

Junghans²,

Lorenz³

et al. 2003

Oncology

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Objectives: MIB-1 and p53 protein expression, loss of heterozygosity (LOH), microsatellite instability (MSI) of di- and mononucleotide repeats, and HPV status were tested for their potential to characterize different stages of epithelial hyperplastic laryngeal lesions (EHLL). Methods: Thirty-two EHLL were reclassified according to the Ljubljana classification into simple (SH), abnormal (AbH), atypical hyperplasia (AtH) and carcinoma in situ, and investigated by immunohistochemical methods, PCR and direct sequencing analysis. Results: MIB-1 increased with progressive grades of EHLL, whereas p53 protein expression was distinctive only between SH and AbH. LOH showed increasing frequency with grades of the lesions, but the distribution of altered loci (9p, 9q, 10q, 11q, 17p) was not qualified to differentiate between the stages. MSI was detected in SH, AbH and AtH without clear correlation to histopathological grading. HPV infection occurred mostly in SH and AbH (both: 66.7%). Conclusion: MIB-1 labeling and allelic loss could assist histopathological diagnosis in the entire spectrum of EHLL, whereas the MSI results point to a genetic instability of the laryngeal mucosa in general and are therefore not helpful in the distinction of different stages of EHLL. However, future molecular genetic analyses should consider more late events of laryngeal carcinogenesis to improve their diagnostic potential. Furthermore, our results indicate that nonrisky and risky EHLL could probably be caused by different exogenous factors.

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Section: Discussioncontrasting

confidence: 68%

The Supplementary Diagnostic Power of Selected Immunohistochemical, Molecular Genetic and Infective Parameters in Epithelial Hyperplastic Laryngeal Lesions

Kleist

Junghans²,

Lorenz³

et al. 2003

Oncology

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“…Numerous schemes for the classification of laryngeal dysplasia have been proposed without any readily accepted final agreed criteria 2, 9 . A recent publication illustrated a wide divergence of diagnoses though the paper is clouded by new terminology which clarifies neither histological features nor prognostic potential 10 .…”

Section: Discussionmentioning

confidence: 99%

“…In fact, our group had a reasonable Kappa statistic of 0.57 in the distinction of the equivalent categories, mild and moderate from severe dysplasia and CIS. After criteria had been agreed, the Ljubljana group 8–10 found almost complete unanimity in the reassessment of the biopsies. Our findings compare favourably with the uninstructed results produced by that working group 10 …”

Section: Discussionmentioning

confidence: 99%

Consistency of histopathological reporting of laryngeal dysplasia

et al. 2000

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Our group had a satisfactory agreement on the distinction of mild from severe dysplasia and on microinvasive carcinoma without any discussion as to histopathological criteria to be used. Clinical management--review endoscopy, repeat cord stripping, radiotherapy and laryngectomy--is in general dependent on histological assessment. Thus the agreement on categories which underpin clinical management is reassuring. However, assessment of moderate dysplasia remains problematic. An attempt to utilize a two grade system--low grade from high grade dysplasia/CIS--may have merit. The implications of the terminology used must be agreed among pathologists and clinicians working closely within clinicopathological cancer groups.

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“…Sir : We have recently presented a detailed description of the criteria that can be used for the grading of laryngeal epithelial hyperplastic lesions in the Ljubljana classification 1 . In his Commentary, published in the same issue of Histopathology , Helliwell has usefully discussed the histopathological guidelines given by the Ljubljana classification 2 . We agree with Helliwell's stipulation that further evaluation of this system in histopathological practice is required.…”

mentioning

confidence: 81%

Ljubljana classification of epithelial hyperplastic laryngeal lesions

Michaels

1999

Histopathology

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‘Risky’ epithelium in the larynx — a practical diagnosis?

Cited by 13 publications

References 20 publications

The Supplementary Diagnostic Power of Selected Immunohistochemical, Molecular Genetic and Infective Parameters in Epithelial Hyperplastic Laryngeal Lesions

The Supplementary Diagnostic Power of Selected Immunohistochemical, Molecular Genetic and Infective Parameters in Epithelial Hyperplastic Laryngeal Lesions

Consistency of histopathological reporting of laryngeal dysplasia

Ljubljana classification of epithelial hyperplastic laryngeal lesions

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