Department of Pathology, NCI, Cairo University, Giza, Egypt.
Pathol Oncol Res. 2020 Jan;26(1):515-520. doi: 10.1007/s12253-018-0560-z. Epub 2018 Nov 27.
The precise typing of precursor lesions of squamous cell carcinoma of vocal cord is of vital importance since it determines the line of therapy and prognosis. The aim of the present study is to evaluate the possible value of the types of dyskeratosis, histometry and cell proliferation rate in discriminating these lesions. The present retrospective study was based on 145 patients, classified according to the updated 2017 WHO system and included: Low-grade dysplasia (24 cases), high -grade dysplasia (53 cases), carcinoma insitu (33 cases) and microinvasive carcinomas (35 cases). Cell proliferation was assessed by immunoreactivity to Ki-67. For histometry and quantitation of Ki-67 proliferation rate, an image analysis system was used (Leica LAS, Wetzlar, Germany). Epithelial pearls (cell nests) were commonly observed in microinvasive carcinoma (82.9%) than high-grade dysplasia (5.9%). The median epithelial thickness, as well as, proliferation rate showed a significant increase according to the grade of the lesion. It is concluded that dyskeratosis pattern, histometry and Ki-67proliferation rate are valuable parameters to characterize precursor lesions. The presence of epithelial pearls, thickness > 450 μm and Ki-67 > 40% denote high risk lesions that require adequate excision and/or radiotherapy.
声带鳞状细胞癌前病变的精确分型至关重要，因为它决定了治疗方案和预后。本研究旨在评估角化不良的类型、组织计量学和细胞增殖率在鉴别这些病变中的可能价值。本回顾性研究基于 145 例患者，根据 2017 年 WHO 系统进行了分类，包括：低级别异型增生（24 例）、高级别异型增生（53 例）、原位癌（33 例）和微浸润癌（35 例）。细胞增殖通过 Ki-67 免疫反应性进行评估。对于组织计量学和 Ki-67 增殖率的定量，使用图像分析系统（Leica LAS，Wetzlar，德国）。微浸润癌（82.9%）比高级别异型增生（5.9%）更常见上皮珠（细胞巢）。上皮厚度和增殖率的中位数随着病变程度的增加而显著增加。结论：角化不良模式、组织计量学和 Ki-67 增殖率是特征性前病变的有价值参数。上皮珠的存在、厚度＞450μm 和 Ki-67＞40%表示需要充分切除和/或放疗的高危病变。
