Tavaluc Raluca, Herman Howard, Lin Juan, Tan Melin
1 Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
2 Albert Einstein College of Medicine, Bronx, New York, USA.
Ann Otol Rhinol Laryngol. 2018 Nov;127(11):812-816. doi: 10.1177/0003489418796529. Epub 2018 Sep 6.
Reinke's edema (RE) is a benign disease of the vocal folds with a wide spectrum of clinical severity. We aim to evaluate the clinical impact of RE grade and determine if RE grade correlates with severity of dysplasia and tobacco exposure.
Patients with isolated RE who underwent surgical excision between December 2010 and December 2014 were retrospectively reviewed. The RE grade was determined from archived laryngeal videostroboscopy exams. Pathologic severity of dysplasia, categorized by squamous intraepithelial neoplasia (SIN) classification, and tobacco history were extracted from medical records.
Of 95 lesions, 3 (3.16%) were RE grade 1, 33 (34.74%) were RE grade 2, 24 (25.26%) were RE grade 3, and 35 (36.84%) were RE grade 4. Fifty-nine lesions (62.11%) had no dysplasia (SIN0), 19 (20.00%) had mild dysplasia (SIN1), 15 (15.79%) had moderate dysplasia (SIN 2), and 2 (2.11%) had severe dysplasia (SIN3). The 2 patients with severe dysplasia had grade 4 lesions. No statistical correlation was identified between RE grade and the severity of dysplasia. Furthermore, no statistical correlation was seen between tobacco exposure and the severity of dysplasia or the RE grade.
Size of RE lesion does not reflect premalignancy. The majority of RE lesions, regardless of size, have little to no premalignant potential. Severe dysplasia/carcinoma in situ may be more likely seen in grade 4 lesions; however, the paucity of severe dysplasia published in RE data and in this cohort preclude any formal inference. Further study of grade 4 lesions is warranted.
任克氏水肿（RE）是一种声带良性疾病，临床严重程度范围广泛。我们旨在评估RE分级的临床影响，并确定RE分级是否与发育异常的严重程度和烟草暴露相关。
对2010年12月至2014年12月期间接受手术切除的孤立性RE患者进行回顾性研究。RE分级由存档的喉镜频闪检查确定。从病历中提取发育异常的病理严重程度（按鳞状上皮内瘤变（SIN）分类）和吸烟史。
95个病变中，3个（3.16%）为RE 1级，33个（34.74%）为RE 2级，24个（25.26%）为RE 3级，35个（36.84%）为RE 4级。59个病变（62.11%）无发育异常（SIN0），19个（20.00%）有轻度发育异常（SIN1），15个（15.79%）有中度发育异常（SIN 2），2个（2.11%）有重度发育异常（SIN3）。2例重度发育异常患者有4级病变。未发现RE分级与发育异常严重程度之间存在统计学相关性。此外，未发现烟草暴露与发育异常严重程度或RE分级之间存在统计学相关性。
RE病变大小不能反映癌前病变情况。大多数RE病变，无论大小，癌前病变潜能很小或没有。4级病变中可能更易出现重度发育异常/原位癌；然而，RE数据及本队列中重度发育异常病例较少，无法进行任何正式推断。有必要对4级病变进行进一步研究。
