1. Evaluation of a new grading system for laryngeal squamous intraepithelial lesions--a proposed unified classification.
- Author
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Gale N, Blagus R, El-Mofty SK, Helliwell T, Prasad ML, Sandison A, Volavšek M, Wenig BM, Zidar N, and Cardesa A
- Subjects
- Disease Progression, Humans, Slovenia, Epithelial Cells pathology, Laryngeal Mucosa pathology, Laryngeal Neoplasms pathology, Neoplasm Grading methods, Precancerous Conditions classification, Precancerous Conditions pathology
- Abstract
Aims: To verify the applicability, reproducibility and predictive value of a proposed unified classification (amended Ljubljana classification) for laryngeal squamous intraepithelial lesions (SILs)., Methods and Results: Six internationally recognized experts and three pathologists from Ljubljana contributed to this study by evaluating a set of laryngeal SILs using the new system: low-grade SIL, high-grade SIL, and carcinoma in situ (CIS). The overall agreement among reviewers was good. Overall unweighted and weighted κ-values and 95% confidence intervals were 0.75 (0.65-0.84) and 0.80 (0.71-0.87), respectively. The results were stratified between the international reviewers and the Ljubljana pathologists. The former had good overall agreement, and the latter had very good agreement. Kaplan-Meier survival curves showed a significant difference (P < 0.0001) between patients with low-grade and high-grade SILs; 19 of 1204 patients with low-grade SILs and 30 of 240 patients with high-grade SILs progressed to malignancy in 2-15 years and in 2-26 years, respectively., Conclusions: The proposed modification to the Ljubljana classification provides clear morphological criteria for defining the prognostic groups. The criteria facilitate better interobserver agreement than previous systems, and the retrospective follow-up study demonstrates a highly significant difference in the risk of malignant progression between low-grade and high-grade SILs., (© 2014 John Wiley & Sons Ltd.)
- Published
- 2014
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