Robert Šifrer1,2, Maja Šereg-Bahar3,4, Nina Gale5, Irena Hočevar-Boltežar3,4. 1. University Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia. robert_sifrer@hotmail.com. 2. Faculty of Medicine, Korytkova 2, 1000, Ljubljana, Slovenia. robert_sifrer@hotmail.com. 3. University Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia. 4. Faculty of Medicine, Korytkova 2, 1000, Ljubljana, Slovenia. 5. Institute of Pathology, Faculty of Medicine, Korytkova 2, 1000, Ljubljana, Slovenia.
Abstract
PURPOSE: According to the classification of glottic lesions by narrow-band imaging (NBI) proposed by the European Laryngological Society (ELS), lesions without perpendicular patterns are benign, while wide- and narrow-angled perpendicular lesions include both papilloma and carcinoma/high-grade lesions, respectively. The purpose of the study was to investigate the effectiveness of the ELS classification. METHODS: One hundred and forty four patients with glottic lesions underwent microlaryngoscopy with NBI. The affected vocal cords (arm A) were histologically analysed. The unaffected vocal cords (arm B) were not histologically analysed and were considered to be true negatives if no suspicious changes appeared during the follow-up. The vocal cords from arm A were categorised into three groups-those with a benign disease (papilloma excluded), those with a carcinoma/high-grade lesion and those with papilloma. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test. RESULTS: Perpendicular patterns were identified only in 9.3% (9/97) of those in the benign group (without papilloma). Wide-angled patterns were mainly identified in cases of papilloma (80%, 12/15), while the narrow-angled ones were mostly identified in cases of carcinoma and high-grade lesions (96.2%, 76/79) (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 98%, 95%, 88%, 99% and 95%, respectively. CONCLUSION: The ELS classification of vocal cord lesions by NBI is effective in differentiating between carcinoma/high-grade lesions and papilloma and the remaining benign lesions of the vocal cords.
PURPOSE: According to the classification of glottic lesions by narrow-band imaging (NBI) proposed by the European Laryngological Society (ELS), lesions without perpendicular patterns are benign, while wide- and narrow-angled perpendicular lesions include both papilloma and carcinoma/high-grade lesions, respectively. The purpose of the study was to investigate the effectiveness of the ELS classification. METHODS: One hundred and forty four patients with glottic lesions underwent microlaryngoscopy with NBI. The affected vocal cords (arm A) were histologically analysed. The unaffected vocal cords (arm B) were not histologically analysed and were considered to be true negatives if no suspicious changes appeared during the follow-up. The vocal cords from arm A were categorised into three groups-those with a benign disease (papilloma excluded), those with a carcinoma/high-grade lesion and those with papilloma. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test. RESULTS: Perpendicular patterns were identified only in 9.3% (9/97) of those in the benign group (without papilloma). Wide-angled patterns were mainly identified in cases of papilloma (80%, 12/15), while the narrow-angled ones were mostly identified in cases of carcinoma and high-grade lesions (96.2%, 76/79) (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 98%, 95%, 88%, 99% and 95%, respectively. CONCLUSION: The ELS classification of vocal cord lesions by NBI is effective in differentiating between carcinoma/high-grade lesions and papilloma and the remaining benign lesions of the vocal cords.
Authors: Boudewijn E C Plaat; Manon A Zwakenberg; Joost G van Zwol; Jan Wedman; Bernard F A M van der Laan; György B Halmos; Frederik G Dikkers Journal: Head Neck Date: 2017-03-29 Impact factor: 3.147
Authors: Christoph Arens; Cesare Piazza; Mario Andrea; Frederik G Dikkers; Robin E A Tjon Pian Gi; Susanne Voigt-Zimmermann; Giorgio Peretti Journal: Eur Arch Otorhinolaryngol Date: 2015-12-17 Impact factor: 2.503
Authors: Nina Gale; Douglas R Gnepp; Mario Poljak; Primož Strojan; Antonio Cardesa; Tim Helliwell; Robert Šifrer; Metka Volavšek; Ann Sandison; Nina Zidar Journal: Adv Anat Pathol Date: 2016-03 Impact factor: 3.875
Authors: Petr Lukes; Michal Zabrodsky; Eva Lukesova; Martin Chovanec; Jaromir Astl; Jaroslav A Betka; Jan Plzak Journal: Biomed Res Int Date: 2014-06-17 Impact factor: 3.411
Authors: Robert Šifrer; Johannes A Rijken; C René Leemans; Simone E J Eerenstein; Stijn van Weert; Jan-Jaap Hendrickx; Elisabeth Bloemena; Derrek A Heuveling; Rico N P M Rinkel Journal: Eur Arch Otorhinolaryngol Date: 2017-10-30 Impact factor: 2.503