Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey.
Department of Otorhinolaryngology & Head and Neck Surgery, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli, Turkey.
J Voice. 2022 Nov;36(6):882.e9-882.e15. doi: 10.1016/j.jvoice.2020.10.003. Epub 2020 Nov 4.
The purpose of this study was to investigate the rate of concordance between indirect- and direct laryngoscopy and final pathology in patients undergoing laryngeal microsurgery.
Retrospective case study.
This study was conducted in the Otolaryngology clinic of a tertiary center between January 2017 and June 2020. Archives records of 432 patients, who underwent laryngeal microsurgery because of benign and premalignant lesions or malignancy, were examined. The patients were divided into three subgroups according to pathology results: benign lesions, premalignant lesions, and malignancies.
There were 400 laryngeal lesions from 385 patients, that met the inclusion and exclusion criteria, 307 (79.7%) were male and 78 were (20.3%) female. The average age of patients was 52.88 ± 13.21 years. The most common diagnosis was polyp (34.25%) followed by squamous cell carcinoma (27.75%) and Reinke's edema (8.25%) according to final pathology. For the benign laryngeal lesions, a high correlation level was observed regarding the compatibility of the indirect- and direct laryngoscopy diagnosis, and final pathology (P < 0.001). The laryngeal premalignant lesions and malignancies were significantly more common in older age and male gender (P <0.001). Similarly, smoking usage was more frequent in patients with premalignant lesions and malignancy (P <0.001). The neutrophil count, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP value were significantly higher in malignancy group (P <0.05). On the other hand, lymphocyte ratio was smaller in the malignancy group compared with the benign and premalignant lesions, and this difference was significant (P = 0.016).
Our study demonstrated a high rate of agreement between the clinical diagnosis and pathology results in patients with benign laryngeal lesions, in contrast to premalignant lesions and malignancies. Also, the neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, neutrophil to platelet ratio as well as CRP were shown to be increased in patients with laryngeal malignancies.
本研究旨在调查行喉显微手术的患者间接喉镜和直接喉镜与最终病理检查的符合率。
回顾性病例研究。
本研究于 2017 年 1 月至 2020 年 6 月在一家三级中心的耳鼻喉科诊所进行。检查了 432 例因良性和癌前病变或恶性肿瘤而行喉显微手术的患者的档案记录。根据病理结果将患者分为三组：良性病变、癌前病变和恶性肿瘤。
符合纳入和排除标准的 385 例患者中有 400 个喉部病变，其中 307 例（79.7%）为男性，78 例（20.3%）为女性。患者的平均年龄为 52.88 ± 13.21 岁。根据最终病理结果，最常见的诊断是息肉（34.25%），其次是鳞状细胞癌（27.75%）和 Reinke 水肿（8.25%）。对于良性喉部病变，间接喉镜和直接喉镜诊断与最终病理结果之间观察到高度相关（P < 0.001）。喉癌前病变和恶性肿瘤在年龄较大和男性中更为常见（P <0.001）。同样，癌前病变和恶性肿瘤患者的吸烟使用率更高（P <0.001）。中性粒细胞计数、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、中性粒细胞与血小板比值以及 CRP 值在恶性肿瘤组中显著升高（P <0.05）。另一方面，与良性和癌前病变相比，恶性病变组的淋巴细胞比值较小，差异具有统计学意义（P = 0.016）。
本研究表明，在良性喉部病变患者中，临床诊断与病理结果之间具有较高的一致性，而在癌前病变和恶性肿瘤中则不一致。此外，在患有喉癌的患者中，中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、中性粒细胞与血小板比值以及 CRP 均升高。
